,,:5 ,,y ,,don',t ,,"k ,,:]e ,,to ,,turn ,a ,self-,diagnos+ ,guide to ,c\nsel+ & ,!rapy ,/ev5 ,j4 ,b>tlett1 ,ph4,d4 ,contempor>y ,books1 ,inc4 ,*icago -- ,new ,york 99 99 99 99 99 ,,also ,,by ,,/ev5 ,,james ,,b>tlett ,normality ,does ,n ,equal ,m5tal ,heal?3 ,! ,ne$ to ,look ,else:]e = ,/&>ds ( ,good ,psy*ological ,heal? ,! ,pa?ology ( ,man3 ,a ,/udy ( ,human ,evil ,reflexivity3 ,a ,s\rce ,book 9 ,self-,ref]5ce ,self-,ref]5ce3 ,reflections on ,reflexivity 7co-edit$ ) ,pet] ,sub]7 ,conceptual ,!rapy3 ,an ,introduction to ,framework-,relative ,epi/emology ,metalogic ( ,ref]5ce3 ,a ,/udy 9 ! ,f\ndations ( ,possibility ,,validity3 ,a ,le>n+ ,game ,approa* to ,ma!matical ,logic ,z editor ( ^! books by ,paul ,alex&] ,b>tlett3 ,voices f ! ,pa/ -- ,a ,qu9tet ( ,novels3 ,sappho's ,j\rnal ,*ri/'s ,j\rnal ,leon>do da ,v9ci's ,j\rnal ,%akespe>e's ,j\rnal ,l9coln's ,j\rnal ,libr>y ( ,congress ,catalog+-9-,publication ,data ,b>tlett1 ,/ev5 ,j4 ,:5 y don't "k :]e to turn4 ,bibliography3 p4 #a4 ,psy*o!rapy4 #b4 ,c\nsel+4 #c4 ,consum] education4 ,i4 ,title4 ,,rc#dfj4;,b#bh #aihg #faf4hi'ad #hg-bjjde ,,isbn #j-hjib-dhbi-h ,copyright #aihg by ,/ev5 ,j4 ,b>tlett1 ,ph4,d4 ,all rights res]v$ ,publi%$ by ,contempor>y ,books1 ,inc4 #ahj ,nor? ,mi*igan ,av5ue1 ,*icago1 ,ill9ois #fjfja ,manufactur$ 9 ! ,unit$ ,/ates ( ,am]ica ,libr>y ( ,congress ,catalog ,c>d ,numb]3 #hg-bjjde ,int]national ,/&>d ,book ,numb]3 #j-hjib-dhbi-h ,publi%$ simultane\sly 9 ,canada by ,beav]books1 ,ltd4 #aie ,all/ate ,p>kway1 ,valleywood ,bus9ess ,p>k ,m>kham1 ,ont>io ,l#c,r #d,t#h ,canada ,project ,gut5b]g #bjad edition ,note t ?is is a copyright$ ,project ,gut5b]g e,book2 x is n 9 ! public doma94 ,its lic5se1 see bel[1 all[s = free non-comm]cial di/ribution & prohibits its sale or use 9 d]ivative works by anyone )\t ! copyright hold]'s writt5 cons5t4 ,:5 ,y ,don't ,"k ,:]e to ,turn 0 orig9ally publi%$ 9 #aihg by ,contempor>y ,books4 ,all rights to ! book h n[ rev]t$ to ! au?or1 :o has decid$ to make ! book available z an op5 access publication1 freely available to read]s ?r\gh ,project ,gut5b]g "u ! t]ms ( ! ,creative ,commons 99,attribution-,non,commercial-,no,deriv s lic5se991 :i* all[s anyone to di/ribute ?is "w )\t *anges to its cont5t1 provid$ t bo? ! au?or & ! orig9al ,,url f :i* ?is "w 0 obta9$ are m5tion$1 t ! cont5ts ( ?is "w are n us$ = comm]cial purposes or pr(it1 & t ?is "w w n be us$ )\t ! copyright hold]'s writt5 p]mission 9 d]ivative works 7i4e41 y may n alt]1 trans=m1 or build ^u ?is "w )\t su* p]mission74 ,! full legal /atem5t ( ?is lic5se may be f\nd at http3_/_/creativecommons4org_/lic5ses_/b y-nc-nd_/#c4j_/legalcode ,illu/ration3 ,creative,commons,logo4jpg ,?is book is d$icat$ to ,k>51 my love1 wife1 & fri5d4 ,preface to ! ,project ,gut5b]g ,edition ,ne>ly ?ree decades h pass$ s9ce ,:5 ,y ,don't ,"k ,:]e to ,turn 0 fir/ publi%$4 ,9 t "t1 psy*iatry1 cl9ical psy*ology1 & c\nsel+ h *ang$ a good deal4 ,psy*iatry has cont9u$ on a n[ well-worn pa? lead+ to a m & m inflat$ univ]se ( diagno/ic labels1 ! majority ( :i* h no kn[n organic basis4 ,few read]s :o are n !mselves m5tal heal? pr(essionals realize t ^! diagno/ic classifications are vot$ into exi/5ce by committees ( psy*iatri/s ^: pron\ncem5ts magically summon into be+ a l5g!n+ li/ ( s-call$ m5tal disord]s4 ,^! pron\ncem5ts are !n appli$ to p 9 ord] to label _! problems 7z well z ! p :o h !m71 to mat* _! problems ) alleg$ly effective treatm5ts1 & 9 ! process to give ! impression t a respectable m$ical process ( diagnosis & int]v5tion has be5 und]tak54 ,& yet ^! s-call$ m5tal disord]s d little m ?an equate designat$ patt]ns ( behavior1 emotion1 or ?\ght--call$ syndromes--) alleg$ psy*ological malfunction+4 ,su* syndromes are no m ?an sets ( symptoms t c be collect$ toge!r 9 a wide v>iety ( diff]5t ways1 b dep5d+ ^u h[ !y are gr\p$1 di/+ui%able syndromes c be po9t$ to & nam$4 ,?is is a highly arbitr>y process v mu* l =tune-tell+ us+ tea leaves1 :i* dep5ds on ! patt]n se5 or imag9$ 9 ! tea leaves at ! bottom ( a cup4 ,dur+ ! pa/ ?ree decades1 cl9ical psy*ology & its less =mal c\s91 c\nsel+1 h also und]gone noticeable *ange4 ,!y h be5 ! traditional s\rces ( a l>ge numb] ( div]se approa*es to psy*o!rapy & c\nsel+4 ,b 9 ! pa/ ?irty ye>s1 ! l>ge numb] ( approa*es to psy*o!rapy & c\nsel+ has1 9 practical reality1 %runk consid]ably4 ,?is has be5 due to ! rapid dom9ance & virtual monopoly t has be5 ga9$ by cognitive-behavioral !rapy1 also kn[n z rational-emotive !rapy4 ,insurance companies h be5 attract$ l flies to ! sweetness ( ! comp>atively brief treatm5t p]iod t\t$ by cognitive-behavioral !rapy1 & practition]s h simil>ly be5 attract$ by ! ease ( us+ its "o-size-fits-all approa*4 ,& s :]e ! *anges 9 psy*iatry h be5 inflation>y 9 its au?oriz$ catalogue ( m5tal disord]s kn[n z ! ,,dsm 7,diagno/ic & ,/ati/ical ,manual ( ,m5tal ,disord]s71 cl9ical psy*ology & c\nsel+ h be5 on a deflation>y c\rse t has progressively n>r[$ ! treatm5t options available to _m p4 ,despite ! passage ( "t1 ,:5 ,y ,don't ,"k ,:]e to ,turn rema9s ! only /ep-by-/ep self-diagnos+ guide to c\nsel+ & !rapy1 a guide t seeks to direct individuals--by respect+ & respond+ to ! v great diff]5ces t exi/ among individuals--to approa*es to c\nsel+ & !rapy t may be mo/ likely to b5efit !m--tak+ into acc\nt ! nature ( _! own individual problems1 _! diff]5t degrees ( will+ness & abilities to le>n & to *ange1 & _! diff]+ individual situations 9 life1 includ+ _! f9ancial res\rces & ! am\nt ( "t t !y are will+ to devote to !rapy4 ,su* a cu/omiz$1 individually-c5t]$ p]spective is n popul> today4 ,! human population cont9ues inexorably to exp& :ile our heal?c>e sy/em insi/s on g5]al applicability & /reaml9$ effici5cy4 ,individual problems 9 liv+ are m easily & rapidly process$ :5 !y c be subsum$ "u specifiable diagno/ic & treatm5t codes4 ,9 ?is increas+ly me*aniz$ process1 ! individual p]son & ! individual problems ( liv+ he or %e is attempt+ to cope ) t5d m & m to be ignor$ or neglect$1 & 8 or h] diagnosable disease entity becomes ! object ( att5tion4 ,^! comm5ts are n a polemic aga9/ curr5t tr5ds & fa%ions2 !y are r int5d$ to place 9 p]spective ! *anges t h occurr$ 9 ! m5tal heal? field dur+ ! pa/ ?ree decades s9ce ! fir/ edition ( ?is book came (f ! press4 ,:at a read] might take away f ^! prelim9>y rem>ks are ^! sugge/ions3 99 to recognize t1 l s mu* t is a human production1 today's classification sy/em ( m5tal disord]s is unlikely to be ! f9al ^w ab\t ! human condition1 b t its prolif]at+ li/ ( m5tal disord]s %\ld be tak5 by ! humble at lea/ ) a gra9 ( salt1 & reject$ :olesale by ^? :o are m critically incl9$2 99 to accept ! fact t x is becom+ h>d] ) ! passage ( "t to f9d "o's way to a m5tal heal? cl9ician :o is n recipe-ori5t$1 due to ! 9-fa%ion monopoly t prescribes cognitive-behavioral !rapy1 & due to ! pressures on ! heal?c>e sy/em to process p & _! problems fa/] & at l[] co/2 &1 f9ally1 99 to realize t1 :5 x comes to problems ( liv+1 ^? :o are will+ to accept a heal?y measure ( responsibility = _! own *oice ( practition] & treatm5t are mo/ likely to f9d a practition] & a treatm5t t meet _! individual ne$s4 ,f ?is po9t ( view1 ,:5 ,y ,don't ,"k ,:]e to ,turn cont9ues to (f] read]s a height5$ consci\sness ( alt]natives to treatm5t t d /ill cont9ue to available1 ?\gh !y c be some:at h>d] to f9d 9 "s areas ( ! c\ntry1 & to give read]s a s5se ( :at ^? alt]natives h to (f] & = :i* k9ds ( problems & p]sonalities !y may be/ be suit$4 ,read]s int]e/$ 9 le>n+ m ab\t ! au?or1 8 rese>*1 & publications by him1 _m ( :i* c n[ be d[nload$ at no co/1 may l to visit ! au?or's website3 http3_/_/www4willamette4edu_/sb>tlet ,/ev5 ,james ,b>tlett ,salem1 ,oregon #bjad 99 99 99 99 99 ,?is book (f]s c\nsel+ obs]vations bas$ on ! au?or's exp]i5ce only & makes no specific recomm5dations = any individual or gr\p4 ,x is int5d$ & has be5 writt5 to (f] ! au?or's und]/&+ & op9ions 9 reg>d to ! subject matt]4 ,! au?or & publi%] are n "h engag$ 9 provid+ p]sonal psy*ological or psy*iatric or o!r pr(essional advice4 ,= su* advice1 ! read] %\ld seek ! s]vices ( a qualifi$ pr(essional4 ,! au?or & ! publi%] _c be held responsible = any loss incurr$ z a result ( ! application ( any ( ! in=mation conta9$ 9 ?is book4 ,,cont5ts ,be=e ,we ,beg9 444 xi ,ackn[l$gm5ts xv ,! ,purpose ( ,?is ,book #a ,,"p ,i3 ,,gett+ ,,/>t$ #g #a ,prisons ,we ,make = ,ourselves #i #b ,pa?s to ,help #ag #c ,bridges f ,"h to ,!re #bi #d ,! ,!rapeutic ,jungle1 ,"p ,i3 ,social ,work]s1 ,psy*ologi/s1 & ,psy*iatri/s #ci #e ,! ,!rapeutic ,jungle1 ,"p ,,ii3 ,outside ! ,ma9/ream #dh #f ,:]e ,y ,c ,f9d ,help #ed #g ,self-,diagnosis3 ,mapp+ ,y\r ,way to a ,!rapy #ei #h ,emotional ,problems ,t ,may ,h ,physical ,causes #ii ,,"p ,,ii3 ,,exp]i5c+ ,,!rapy #aaa #i ,psy*oanalysis #aac #aj ,psy*o!rapy1 ,"p ,i3 ,cli5t-,c5t]$ ,!rapy1 ,ge/alt ,!rapy1 ,transactional ,analysis1 ,rational-,emotive ,!rapy1 & ,exi/5tial-,humani/ic ,!rapy #abc #aa ,psy*o!rapy1 ,"p ,,ii3 ,logo!rapy1 ,reality ,!rapy1 ,adl]ian ,!rapy1 ,emotional ,flood+ ,!rapies1 ,direct ,decision ,!rapy #aej #ab ,behavioral ,psy*o!rapy #agc #ac ,gr\p ,!rapy #ahd #ad ,m>riage & ,family ,!rapy #aid #ae ,*annel+ ,aw>5ess3 ,ex]cise1 ,bi(e$back1 ,relaxation ,tra9+1 ,hypnosis1 & ,m$itation #bjd #af ,drug & ,nutrition ,!rapies #bbg ,,"p ,,iii3 ,,important ,,que/ions #bci #ag ,locat+ a ,!rapi/ #bda #ah ,%\ld ,y ,be ,hospitaliz$8 #beb #ai ,confid5tiality3 ,y\r ,privacy #beg #bj ,does ,!rapy ,"w8 #bfg #ba ,life ,aft] ,!rapy #bhb ,,"p ,,iv3 ,,app5dixes #bhg ,app5dix ,a3 ,ag5cies & ,organizations ,t ,c ,help 7,unit$ ,/ates & ,canada7 #bhi ,app5dix ,b3 ,sugge/ions = ,fur!r ,read+ #bih ,index #cjg ,,ab\t ,,! ,,au?or #cac xi ,,be=e ,,we ,,beg9 444 99 ,a rec5t /udy by ! ,national ,in/itute ( ,m5tal ,heal? %[s t "o ,am]ican 9 five suff]s f "s type ( psy*iatric disord]3 #ej4e million ,am]icans h "o or ano!r ( eight s]i\s psy*iatric disord]s1 rang+ f anxiety disord]s & phobias to depression & s*izophr5ia4 99 ,( ^!1 only "o p]son 9 five seeks pr(essional help4 ,m ?an #dj1djj1jjj sev]ely tr\bl$ p d n receive any treatm5t4 99 ,an unkn[n numb] ( heal?y1 emotionally untr\bl$ ,am]icans ent] !rapy = reasons ( self-developm5t4 99 ,m ?an #acj di/+ui%able !rapies n[ exi/4 99 ,^! !rapies are (f]$ by a v>iety ( heal? c>e pr(essionals1 includ+ social "w c\nselors1 cl9ical & c\nsel+ psy*ologi/s1 psy*iatri/s1 bi(e$back !rapi/s1 & o!rs4 ,_! backgr\nds1 tra9+1 fees1 & durations ( treatm5t v>y consid]ably4 99 ,^! pr(essionals practice 9 a numb] ( diff]5t sett+s3 9 private practice1 gr\p sessions1 public & private ag5cies1 hospitals1 newly e/abli%$ nonhospital xii inpati5t facilities1 & 9 ! context ( educational programs4 99 ,mo/ p :o ent] !rapy d n "k :at alt]native approa*es to !rapy exi/ or h[ to *oose among !m4 ,!y usually locate a !rapi/ 9 a m or less r&om way4 99 ,mo/ p fe> ! idea ( ent]+ c\nsel+ or psy*o!rapy4 ,!y d n h a cle> conception ( :at to expect3 !y d n "k 9 advance :at ! exp]i5ce ( !rapy is l4 99 ,= a v>iety ( reasons1 _m p :o ?9k ( go+ to a !rapi/ are conc]n$ ab\t :e!r _! relation%ip ) ! !rapi/ w really be confid5tial4 ,if y are especially conc]n$ ab\t privacy1 y %\ld be aw>e ( sev]al ways t confid5tiality may be brok51 :at ! laws conc]n+ confid5tiality are1 &1 9 p>ticul> 7:at few p realize71 h[ insurance claims = psy*ological c>e c invade an individual's privacy4 99 ,c\nselors & !rapi/s t5d to specialize 9 "o or a small numb] ( alt]native approa*es to !rapy4 ,"s approa*es to !rapy are mo/ appropriate = treat+ c]ta9 problems or respond+ to c]ta9 p]sonal int]e/s2 o!rs are bett] suit$ to provid+ help ) o!r problems & conc]ns4 ,*oos+ a !rapi/ ) an ori5tation t is "r = y c be extremely helpful & c help y save mu* "t1 money1 & en]gy4 ,^! facts highlight ! situation 9 c\nsel+ & psy*o!rapy t anyone faces :o ent]s !rapy today4 ,f !m1 y c see t !re is a bewild]+ array ( c\nsel+ pr(essions1 ( di/9ct approa*es to !rapy1 & ( sett+s 9 :i* help is (f]$4 ,?is guide's int5tion & hope is to help y und]/& ! alt]natives1 & to help y =m y\r own judgm5t h[ x may be be/ to proce$4 ,! book hopes to give y real assi/ance s y may make a good *oice--!reby sav+ y emotional inve/m5t1 "t1 money1 & ! pot5tial disc\ragem5t ( avoidable false />ts ) !rapies t may n help because !y are n relevant to y\r goals1 values1 & p]sonality4 xiii ,be pati5t4 ,take ! "t to ?9k ab\t y\rself1 y\r life1 & y\r hopes = a bett] life4 ,?is book 0 writt5 = y1 to help y to improve y\r life1 y\r self-e/eem1 & y\r relation%ips ) o!rs4 ,!y are wor?y goals4 ,no?+ 9 ?is _w c mean z mu*4 ,may y h ! en]gy1 c\rage1 & p]sev]ance to a*ieve !m6 xv ,,ackn[l$gm5ts ,i w\ld l to express my gratitude to ,dr4 ,william ,altus1 !n ,pr(essor ( ,psy*ology at ! ,univ]sity ( ,cali=nia1 ,santa ,b>b>a1 :o w5t out ( 8 way to enc\rage my fir/ int]e/s 9 psy*o!rapy :5 ,i 0 a graduate /ud5t !re tw5ty ye>s ago4 ,to ,pr(essor ,paul ,ricoeur1 ,i w\ld l to express my admiration = 8 orig9al contributions to ,freud s*ol>%ip & my endur+ gratitude = 8 will+ness to direct my doctoral rese>* at ! ,univ]sit de ,p>is4 ,i am indebt$ to ,dr4 ,raphael ,becv>1 ,pr(essor1 ,m>riage & ,family ,!rapy1 ,sa9t ,l\is ,univ]sity1 bo? = mak+ x possible = a faculty colleague to le>n f him 9 sev]al ( 8 excell5t sem9>s & = 8 lat] comrade%ip4 ,to my good fri5d1 ,dr4 ,?omas ,maloney1 cl9ical psy*ologi/ 9 ,clayton1 ,miss\ri1 ,i want to ext5d my w>me/ appreciation = 8 p]sonal guidance & volunt>y sup]vision ( my fir/ ef=ts 9 c\nsel+4 ,if ev] ! qualities ( compassion1 dep? ( und]/&+1 humor1 & g5u9e c>e are to be f\nd 9 "o p]son1 !y are 9 him4 ,i w\ld also l to ?ank ,pr(essor ,lillian ,weg]1 ,george ,w>r5 ,br[n ,s*ool ( ,social ,"w1 ,wa%+ton ,univ]sity1 ,/4 ,l\is1 = g5]\sly welcom+ me into h] f9e sem9> 9 psy*odynamic models4 xvi ,i especially ?ank ,dr4 ,r5ate ,tes* & ,pr(essor ,hallock ,h(fman1 ( ! ,psy*ology ,faculty ( ! ,field+ ,in/itute 9 ,santa ,b>b>a1 = mak+ possible a writ]'s retreat 9 ! ,cali=nia des]t3 ! loan ( _! home 9 ,sky ,valley made writ+ ! la/ gr\p ( *apt]s a special & memorable pleasure4 ,"o is =tunate to h su* fri5ds4 ,if ?is book became m readable aft] its fir/ draft1 x 0 due 9 great "p to ! consci5ti\s en]gy ( my wife1 ,k>51 9 spott+ ! we$s ( obfuscation t seem to gr[ ef=tlessly 9 an academic's g>d54 ,i want to ?ank h] = h] pati5ce1 ) bo? me & ! book4 ,i w\ld also l to take ?is opportunity to ?ank ,miss ,libby ,mc,greevy1 ,assi/ant ,editor1 ,contempor>y ,books1 ,inc41 = h] helpful sugge/ions & = h] regul> doses ( enc\ragem5t t made writ+ ?is book a happy exp]i5ce4 #a ,:5 ,y ,don't ,"k ,:]e ,to ,turn ,,! ,,purpose ,,( ,,?is ,,book ,i w\ld l to introduce ?is book by tell+ y :at happ5$ to a real & likable p]son :o ran into "s v difficult times & z a result ent]$ !rapy4 ,frank is a l>ge man1 a =m] college football play]1 p[]fully built4 ,he has always prid$ himself on 8 /r5g? & det]m9ation4 ,he us$ to be fri5dly & outgo+4 ,he _h a pleasant smile1 complem5t$ by 8 cle> blue eyes4 ,frank _h work$ = elev5 ye>s = a manufactur] ( tools4 ,n long ago1 he 0 promot$ to ! position ( manag+ ! company's sales division 9 a l>ge midwe/]n city4 ,soon aft] ,frank & 8 wife mov$1 8 wife became pregnant ) _! ?ird *ild4 ,frank _h a well-pay+ job1 excell5t b5efits1 a pleasant home !y _h j b\ght1 & a cont5t$ relation%ip ) 8 wife4 ,b 9 spite ( ^! ?+s1 he became sev]ely depress$4 ,& he began to feel t]ribly fright5$3 he _h to leave 8 desk sev]al times ea* morn+ & aga9 9 ! aft]noon4 ,he w\ld g to ! m5's room1 lock ! door1 turn on ! wat] faucets1 & cry4 ,frank lo/ fifte5 p\nds 9 ?ree mon?s4 ,he _h a poor appetite1 slept badly1 & 0 v anxi\s ar\nd 8 #b co-work]s4 ,he c\ldn't und]/& :at _h happ5$ to him1 & he 0 unwill+ to let o!rs "k h[ unhappy he felt4 ,he 0 a%am$ ( :at he took to be a weakness 9 himself3 l _m m51 he 0 rais$ to believe t m5 %\ldn't cry1 & 8 cry+ b\ts %ook 8 s5se ( id5tity & /ability4 ,8 m>riage began to suff]4 ,frank & 8 wife seldom made love4 ,frank 0 irritable & impati5t ) 8 wife & 8 *ildr54 ,frank's wife knew he 0 v tr\bl$1 b he refus$ to talk to h] ab\t x4 ,= sev]al mon?s1 ,frank f\ght aga9/ 8 depression4 7,if only he _h be5 aw>e ( ! /r5g? t he mu/]$ to d ?is67 ,!n he rea*$ a crisis & c\ld n =ce himself to g to "w4 ,he /ay$ home ) a bad cold1 slept z mu* z he c\ld1 & 0 v %ort-temp]$4 ,he 0 cry+ a good deal4 ,frank's wife p]suad$ him to see a doctor4 ,! doctor ref]r$ him to a psy*iatri/4 ,! psy*iatri/ saw ,frank twice a week = two-&-a-half mon?s1 b ,frank 0 tr\bl$ by side effects f ! antidepressant m$ication he took "u ! psy*iatri/'s sup]vision4 ,he resi/$ ! idea ( tak+ drugs1 s he decid$ to see a psy*o!rapi/ :o1 9 coop]ation ) ! psy*iatri/1 monitor$ ,frank's condition z he gradually w5t (f ! antidepressants4 ,h[ev]1 aft] five mon?s1 ,frank did n feel he 0 mak+ any real progress4 ,he *ang$ to ano!r !rapi/ :o1 8 wife _h he>d1 specializ$ 9 ! treatm5t ( depression4 ,toge!r1 ,frank & 8 new !rapi/ came1 ov] a p]iod ( mon?s1 to recognize t ,frank's depression _h result$ f two conflicts3 ,frank _h hat$ 8 job b _h refus$ to admit ?is to himself1 & n[ 8 wife 0 pregnant aga91 & because ( ?is add$ f9ancial responsibility he felt =c$ to /ay ) 8 pres5t job1 :]e he _h s5iority1 good sal>y1 & b5efits4 ,once ! basis = 8 depression 0 made cle>1 x 0 possible to beg9 to treat ,frank's problem4 ,8 wife 0 v will+ to enc\rage him to plan = a *ange ( jobs1 ev5 ?\gh ?is w\ld mean a tempor>y r$uction 9 8 income4 ,frank saw a vocational !rapi/ & receiv$ guidance t l$ him to take "s ev5+ classes & !n to become a comput] programm] = a rapidly gr[+ local company4 ,8 #c depression fad$ away1 & he n[ seems g5u9ely to be cont5t4 ,,:at ,,y ,,c ,,expect ,,f ,,?is ,,book ,i knew ,frank p]sonally1 z 8 !rapi/ 9 a gr\p4 7,8 "n1 l all o!rs 9 ?is book1 has be5 *ang$1 along ) c]ta9 details ab\t 8 situation47 ,) pr(essional help1 ,frank 0 able to improve 8 life--8 s5se ( self-e/eem1 8 m>riage1 & 8 family life4 ,x 0 a long & pa9ful process1 z mu* self-*ange c be4 ,b p]haps ,frank's exp]i5ce might h be5 less pa9ful1 p]haps ,frank might h felt less deva/at+ isolation1 & p]haps 8 pa? to a resolution ( 8 difficulties c\ld h be5 %ort5$ if a practical guide to c\nsel+ & !rapy _h be5 available to him :5 he fir/ decid$ to f9d help4 ,,mak+ ,,intellig5t ,,*oices ,?is book is ab\t h[ y c get ! mo/ appropriate k9d ( help = y\r problems1 goals1 & p]sonality4 ,specifically1 ,:5 ,y ,don't ,"k ,:]e to ,turn sets out to help y become adequately in=m$ ab\t ! range ( !rapi/s & !rapies--z ^! relate to y\r own assessm5t ( y\r goals & int]e/s--s t y w be able to make intellig5t decisions ab\t ^! issues3 99 ! k9d ( pr(essional to seek out 99 ! type ( !rapy mo/ likely to help y ) a c]ta9 compla9t or set ( int]e/s & values 99 h[ to locate ! =m ( !rapy t seems mo/ promis+ to y at a price y c af=d & ) an expect$ duration y c live ) 99 :at sett+ to look = 9 :i* ! help y w\ld l is (f]$ ,?is book uses two approa*es1 bo? pres5t$ "h = ! fir/ "t & bo? bas$ on common s5se & intellig5t advance plann+4 #d ,fir/1 y w be able1 ?r\gh a s]ies ( c>efully organiz$ que/ions & easily foll[$ in/ructions 9 ,"p ,i1 to p9po9t "o or m approa*es to !rapy t may be mo/ promis+ giv5 y\r initial objectives1 problems1 or int]e/s4 ,= ! fir/ "t1 a self-diagnos+ map to ! major approa*es to !rapy is made available4 ,second1 y w h ! opportunity to glimpse :at typically happ5s dur+ ! sessions ( c\nselors1 psy*ologi/s1 & psy*iatri/s z !y treat cli5ts or pati5ts us+ ! diff]5t ma9 approa*es to !rapy4 ,y w come to see :at ! exp]i5ce ( !rapy is l 9 ^! diff]5t approa*es4 ,9 o!r words1 ! self-diagnos+ map w po9t y 9 ! direction ( "o1 & sometimes m ?an "o1 approa* to !rapy t may be mo/ promis+ = y to beg9 ! process ( self-*ange1 & y w !n be able to ga9 an insid]'s p]spective on t approa* s t y c judge h[ well suit$ to y ! approa* is & h[ x comp>es to ! o!r ma9 approa*es to !rapy4 ,if ?is guide helps y *oose a pa? to ! k9d ( !rapy t w be appropriate & useful to y1 x w h done some?+ wor?:ile4 ,a guide to c\nsel+ & psy*o!rapy %\ld1 h[ev]1 d m ?an ?is4 ,,ov]com+ ,,isolation ,,& ,,gett+ ,,/>t$ ,p :o are tr\bl$ t5d to try to hide x4 ,!y frequ5tly isolate !mselves :5 !y are di/ress$1 s ov]com+ ! desire to )draw is ! fir/ ord] ( bus9ess if !y are to improve _! lives & feel+s4 ,"o ( ! ?+s ?is book sets out to d is to help y see t v likely ! problems y are fac+ are n "o ( a k9d4 ,y h a lot ( company2 ! difficulties y are hav+ are probably v famili> to c\nselors & !rapi/s4 ,realize t !re are ways ( resolv+ mo/ problems & t do+ s (t5 is easi] ) ! sympa?y1 empa?y1 moral support1 fri5d%ip1 or direction ( a c\nselor or !rapi/ ?an by y\rself4 ,,c ,,y ,,help ,,y\rself8 ,h[ev]1 sometimes x is possible to help y\rself a great deal #e ?r\gh y\r own initiative4 ,?is book w describe ways t y c be y\r own s\rce ( help & w pay p>ticul> att5tion to :5 x may be appropriate & safe to rely ^u inn] res\rces4 ,,cle>+ ,,! ,,confus+ ,,jungle ,mo/ p are n famili> ) ! diff]5ces among ! ma9 k9ds ( psy*osocial help+ pr(essionals--! v>i\s types ( c\nselors1 cl9ical psy*ologi/s1 psy*iatri/s1 psy*o!rapi/s1 psy*oanaly/s1 social work]s1 etc4 ,ano!r purpose ( ?is book is to cl>ify ^! labels1 to describe h[ ! approa*es us$ by _! practition]s are di/9ct & h[ !y are simil>1 & to give an idea ( h[ _! fees & durations ( treatm5t v>y4 ,individual *apt]s 9 ,"p ,,ii are devot$ to describ+ ! ma9 v>ieties ( !rapy available today3 psy*oanalysis2 psy*o!rapies2 behavior-*ang+ !rapies2 m>riage & family !rapy2 gr\p !rapies2 ex]cise1 bi(e$back1 relaxation1 hypnosis1 & m$itation2 & drug !rapy4 ,ea* approa* w be describ$ 9 ! context ( exp]i5c+ pr(essional help & 9 t]ms ( h[ & :5 x may be possible to apply ! approa* on y\r own4 ,^! *apt]s w help y und]/& :at 9 g5]al to expect if y *oose a p>ticul> k9d ( treatm5t1 h[ ! c\rse ( treatm5t may g1 & :at po9t ( view is %>$ by pr(essionals :o use x4 ,,f9d+ ,,someone ,,to ,,help ,"p ,,iii ( ?is book w describe h[ y c g ab\t locat+ good pr(essional c>e1 :e!r f a family !rapi/1 an analy/1 a social work]1 a psy*iatri/1 a cl9ical psy*ologi/1 or ano!r k9d ( !rapi/4 ,y w le>n h[ y c f9d a reputable pr(essional ) a p>ticul> specialization1 & y w be enc\rag$ to ask him or h] "s useful que/ions be=e beg9n+ treatm5t4 ,z we w see 9 detail lat] on1 !re are num]\s sett+s 9 :i* c\nselors & !rapi/s "w4 ,_m are 9 private practice1 b _m also "w = a v>iety ( ag5cies1 bo? public & private1 = hospitals & newly e/abli%$ nonhospital resid5tial facilities1 & ev5 = educational in/itutions4 ,we #f w discuss ea* ( ^! sett+s 9 ,"p ,,iii s t y w h a cle> idea bo? ( ! alt]natives t exi/ & ( important factors to consid] :5 decid+ among !m4 ,,%\ld ,,y ,,be ,,hospitaliz$8 ,%\ld ,i cons5t to hospitalization8 ,:at w ,i enc\nt] if ,i accept hospitalization8 ,is x necess>y1 is x desirable8 ,ano!r *apt] 9 ,"p ,,iii is devot$ to answ]+ ^! & relat$ que/ions4 ,,is ,,y\r ,,privacy ,,protect$8 ,9 _m ways x w be1 & 9 o!r ways x may n be4 ,confid5tiality z x relates to ! treatm5t ( emotional or psy*ological difficulties is a ?orny issue1 "o t worries _m p4 ,9 ,"p ,,iii1 a *apt] is devot$ to a discussion ( ?is pot5tially important area ( p]sonal conc]n4 ,,does ,,!rapy ,,"w8 ,y may1 ( c\rse1 feel a c]ta9 am\nt ( skepticism ab\t ! real utility & effectiv5ess ( any "o ( ! _m !rapies t n[ exi/4 ,?is is1 9 my judgm5t1 a heal?y skepticism4 ,a *apt] 9 ,"p ,,iii w review :at y may be able to expect1 & p]haps %\ld n expect1 9 ! light ( rec5t evaluations ( ! effectiv5ess ( ! ma9 !rapies4 ,to complem5t ^! z yet incomplete sci5tific f9d+s1 ,i w emphasize a measure ( ord9>y common s5se z we g along4 ,,life ,,aft] ,,!rapy ,! la/ *apt] 9 ?is book deals ) :at to expect aft] !rapy4 ,recurr5ces1 future crises--!y (t5 come ) ! package3 life6 ,relapses--re-exp]i5c+ feel+s ( di/ress--h receiv$ too little att5tion4 ,(t51 old habits & feel+s rema9 ) u & reappe> dur+ times ( /ress4 ,too1 we "k t z life goes on1 we ne$ to be able to tackle new problems & new situations & sometimes mu/ h&le unexpect$ crises4 ,*apt] #ba tells y h[ ! exp]i5ce ( !rapy w help y cope ) possible setbacks & ! unc]ta9ties ( ! future4 #g ,,p>ti ,,gett+ ,,/>t$ #i #a ,,prisons ,,we ,,make ,,= ,,ourselves ,:i* ( u is n =ev] a /rang] & alone8 ,?omas ,wolfe1 ,look ,homew>d1 ,angel ,:at o!r dungeon is s d>k z "o's own he>t6 ,:at jail] s inexorable z "o's self6 ,na?aniel ,haw?orne1 ,! ,h\se ( ! ,sev5 ,gables ,:5 y h %ut y\r doors1 & d>k5$ y\r room1 rememb] nev] to say y are alone1 = y are n alone1 b ,god is )91 & y\r g5ius is )94 ,epictetus1 ,disc\rses ,:5 p are 9 pa9 & mo/ ne$ o!rs1 _m wall !mselves 94 ,?is v human t5d5cy is illu/rat$ by a fam\s /ory4 ,9 #aicd1 ,admiral ,ri*>d ,byrd l$ an exp$ition to ,ant>ctica1 :]e he e/abli%$ a base on ! edge ( ! ,ross ,ice ,b>ri]1 #gjj miles nor? ( ! ,s\? ,pole4 ,byrd !n decid$ to set up a small wea!r obs]vation po/ clos] to ! pole1 :i* he *ose to man alone4 ,he w\ld /ay 9 a "o-room cab91 a box #aj t measur$ n9e feet by ?irte5 feet1 l[]$ into a rectangul> hole cut into ! ice to protect ! cab9 f gale-=ce w9ds dur+ ! com+ w9t] mon?s4 ,byrd 0 committ+ himself to a degree ( p]sonal isolation few m5 h ev] tak5 on4 ,:at happ5$ to him 9 ! mon?s ahead reveals some?+ important to psy*ologi/s t all ( u %\ld be> 9 m9d4 ,byrd's m5 left him 9 8 t9y /ation & return$ across ! ice to ! ma9 base #abc miles to ! nor?4 ,w9t] blizz>d conditions soon surr\nd$ ,byrd4 ,he knew he 0 9 = a long p]iod ( solit>y conf9em5t1 ) no hope ( return+ to ! base1 ev5 if a m$ical em]g5cy dem&$ ?is4 ,he c\ld nev] make ! return trip to ! base on 8 own1 & x w\ld be too dang]\s = a team ( m5 to try to get to him 9 ! w9t] d>kness across ! miles ( ice4 ,aft] sev]al mon?s ( isolation1 ,byrd became v ill4 ,he 0 di/ress$ & confus$ ab\t 8 condition--nausea1 vomit+1 t]rible heada*es1 blurr$ vision1 great weakness4 ,days w\ld g by1 & he w\ld cl+ to life by a ?read1 8 m9d w&]+1 drift+ 9 & out ( ! dizzy+ incoh]5ce ( frequ5t comas4 ,he w\ld1 by %e] =ce ( w1 ga!r 8 res]ve ( fad+ en]gy & /agg] across ! t9y room to light ! /ove & op5 a c ( food1 :i* he soon lo/ f 8 /oma*4 ,gradually1 he came to realize t ! fumes f 8 k]os5e /ove & f ! gasol9e-p[]$ g5]ator = ! telegraph 7 poison+ him4 ,b if he turn$ (f ! /ove1 he w\ld freeze to dea?1 & ! telegraph 0 8 only contact ) o!rs4 ,he knew 8 life 0 9 real dang]1 yet he refus$ to let 8 m5 "k ( 8 desp]ate situation4 ,nor c\ld he admit to himself t he 0 9 tr\ble4 ,li/5 to 8 own words1 writt5 half a c5tury ago1 9 8 sn[-buri$ room ) ! air heavy ) fumes & ! inside walls encru/$ ) gli/5+ ice3 ,x is pa9ful = me to dwell on ! details ( my collapse4444 ,! subject is "o t does n easily be> discussion1 if only because a man's hurt1 l 8 love1 is mo/ seemly :5 conceal$4 ,f my y\? ,i h believ$ t sickness 0 someh[ humiliat+1 some?+ to be kept hidd54444 ,to "s m5 sickness br+s a desire to be left alone2 animal-l1 _! in/9ct is to crawl into a hole & lick ! hurt4 #aa ,!re 7 aspects ( ?is situation :i* ,i w\ld r n m5tion at all1 s9ce !y involve t que] bus9ess call$ self-respect4444 ,= a reason ,i c't :olly expla91 except 9 t]ms ( pride1 ,i conceal$ f my m51 z be/ ,i c\ld1 ! true ext5t ( my weakness4 ,i nev] m5tion$ &1 !re=e1 nev] ackn[l$g$ x4444 ,i want$ no "o to be able to look ov] ! wall4444#a #a ,ri*>d ,e4 ,byrd1 ,alone 7,new ,york3 ,g4 ,p4 ,putnam's ,sons1 #aich71 pp4 #aff1 viii1 #bid-bie4 ,9 spite ( 8 ef=ts to keep 8 condition to himself1 ,byrd's radio op]ator at ! ma9 base seems to h intuit$ t ,byrd 0 9 dang]4 ,a rescue p>ty 0 s5t z ! w9t] wea!r became less h>%1 & ,byrd 0 br\ght back to ! base1 probably j 9 "t1 be=e ! fumes kill$ or p]man5tly injur$ him4 ,9 _m ways1 ,byrd's ,ant>ctic exp]i5ce p>allels t ( _m ( u :o1 because ( our own pa9 & h>d%ip1 isolate ourselves f o!rs4 ,our lives become cold1 desolate1 despair+4 ,our suff]+ is real1 b = "o reason or ano!r we _c or w n rea* out to o!rs4 ,,wall+ ,,y\rself ,,(f ,,f ,,o!rs ,mo/ ( u are aw>e ( a ne$ = human company & companion%ip4 ,b :5 we are 9 pa9 or are sev]ely tr\bl$1 we (t5 =get :at has be5 recogniz$ = a long "t3 ,fr$]ick ,,ii1 ! ?irte5?-c5tury rul] ( ,sicily1 believ$ t all *ildr5 7 born ) a k ( an anci5t language4 ,:5 !y 7 taught ! language ( _! p>5ts1 h[ev]1 he !oriz$1 _! k ( ! old] language 0 ov]ridd5 & blott$ out4 ,k+ ,fr$]ick hypo!siz$ t if *ildr5 7 rais$ )\t be+ taught a language1 !y w\ld1 9 "t1 spontane\sly beg9 to speak 9 "s anci5t tongue4 ,he !re=e appo9t$ a gr\p ( fo/] mo!rs1 _h new-born infants tak5 f _! natural mo!rs1 & ord]$ ! fo/] mo!rs to raise ! *ildr5 9 sil5ce4 ,! up%ot ( ?is e>ly exp]im5t--z ! leg5d goes--0 #ab t ,fr$]ick nev] f\nd out :e!r 8 !ory 0 true4 ,all ( ! babies di$4 ,!y c\ld n live )\t affection1 t\*+1 & lov+ words4 ,app>5tly1 ! fo/] mo!rs )drew all human w>m? :5 !y s\ght to obey ! k+'s ord]4 ,today1 we are aw>e ( a baby's vital ne$ = affection1 = human contact--& ev5 s1 9 our adult lives1 :5 human contact is equally ess5tial1 we sometimes cut ourselves (f f o!rs4 ,,! ,,my? ,,( ,,self-,,suffici5cy ,z adults1 we t5d to emphasize self-control4 ,we ?9k ( ourselves z responsible--to ourselves1 our p>5ts1 our employ]s1 our *ildr54 ,all ?is responsibility c sometimes be a heavy load6 ,dur+ p]iods ( illness or emotional crisis1 ! emphasis on control c be excessive4 ,x c create ! b>s ( a prison1 a grillwork ( def5ses t /&s betwe5 u & o!rs :o are able to (f] enc\ragem5t1 w>m?1 und]/&+1 & direction4 ,!re is no loneli] p]son ?an someone :o has decid$ to take 8 or h] own life4 ,! decision is ! ultimate =m ( self-isolation4 ,x is ! ultimate admission t "o's imprisonm5t is f9al & t !re is no escape4 ,=tunately1 ! decision to take "o's life is rev]sible1 if ! p]son is help$ 9 "t4 ,! help may come f )9 or f )\t1 b x always involves ! recognition ( hope t ! self-imprisonm5t may n be f9al1 t !re are o!rs :o w\ld help1 t1 ev5 = someone :o is t]m9ally ill1 !re may be p]iods ( satisfaction & joy t make liv+ wor?:ile4 ,we/]n ,european1 ,am]ican1 & ,japanese societies are v control-ori5t$4 ,!re is mu* evid5ce t :5 memb]s ( ^! societies are emotionally tr\bl$ !y (t5 p]ceive a fault )9 !mselves4 ,!y see _! tr\bles z spr++ f a loss ( self-control3 ,j pull y\rself toge!r6 ,x's j a matt] ( self-discipl9e1 ( w6 ,! great] our s5se ( responsibility--! m we emphasize p]sonal control ov] our inn] & out] affairs1 ! m we see ourselves z individuali/s ^: individualism is bas$ on /r5g? ( w1 discipl9e1 guts--! m we are trapp$ by ! my? ( self-suffici5cy4 #ac ,p :o z *ildr5 7 =c$ to become indep5d5t too e>ly1 :o lack$ a long en\gh p]iod ( clos5ess to _! mo!rs1 ^: p>5ts 7 immature & self-absorb$ frequ5tly develop :at is call$ pseudo-self-suffici5cy or premature ego developm5t4 ,su* a p]son is ! neurotically extreme =m ( ! d-x-y\rself]4 ,he or %e refuses to rel9qui% control1 :e!r to ! c> me*anic1 ! sew] clean]1 or a lov]4 ,!re is an urg5t & obsessive ne$ to ma9ta9 control1 nev] to be out ( control4 ,= su* p1 anxiety1 depression1 & lonel9ess c be especially deva/at+ because !y h wall$ !mselves 9 to su* an ext5t t emotional gr[? & *ange are block$4 ,yet mo/ ( u %>e1 to "s ext5t1 ?is belief 9 self-suffici5cy4 ,x is "o ( ! mo/ t5aci\s =ms ( self-imprisonm5t t we h available to u1 lit]ally at our own disposal4 ,x is a prison we (t5 take great pride 94 ,pride1 control1 & self-suffici5cy are usually close fri5ds4 ,!y keep u f hav+ real fri5ds & /& 9 ! way ( our be+ good fri5ds to ourselves4 ,,! ,,fe> ,,( ,,be+ ,,label$ ,,emotionally ,,di/urb$ ,x is wov5 into ! fabric ( our society t we %\ld con=m4 ,a "y te5ag] f ,au/ralia n[ 9 a ,cali=nia high s*ool tries z quickly z possible to lose ! acc5t t diff]5tiates h]1 t makes h] ! object ( laught]4 ,! same pressures motivate ! /utt]] to keep quiet1 speak+ only :5 absolutely necess>y4 ,! ,national ,m]it ,s*ol> says a9't among 8 s*ool fri5ds to be "o ( !m4 ,*ildr5 are especially s5sitive to cov]t expectations1 ! implicit %\lds t are h&$ d[n f ! adult _w & are frequ5tly refa%ion$ to fit ! /ages *ildr5 move ?r\gh4 ,at ea* /age1 ! implicit maxims are dress alike1 talk alike1 ?9k alike4 ,be 94 ,especially1 h ! same feel+s1 values1 & hopes4 ,mo/ ( u are rais$ to fe> be+ diff]5t because we might come to be a lonely m9ority ( "o4 ,b :5 we become ill1 especially if we are emotionally tr\bl$1 ! rules *ange radically4 ,animals1 f ! aqu>ium angelfi% to ! h\sehold dog or cat1 seem to h an in/9ct to #ad seek isolation :5 ill4 ,?is t5d5cy probably has evolv$ because x contributes to survival3 ! sick animal c m easily rally its en]gy = self-heal+ 9 quiet1 undi/urb$ by o!rs ( its k9d4 ,& go+ (f to be alone r$uces ! *ance t ! animal w spread any disease x has4 ,add$ to an animal's self-isolat+ t5d5cy is ! t5d5cy to hide ! v signs ( illness or injury4 ,an animal t %[s signs ( injury or illness is imm$iately a t>get = pr$ators :o look = ! weak] memb]s ( ! species4 ,we human be+s also t5d to *oose solitude & to hide ! reveal+ symptoms ( sickness or injury4 ,admiral ,byrd admitt$ to ^! def5ses only 9 8 lonel9ess4 ,b x is important to realize t hid+ our feel+s & isolat+ ourselves frequ5tly are n 9 our be/ int]e/s4 ,animals d n practice m$ic9e1 ?\gh _m species are capable ( (f]+ moral support & ev5 a c]ta9 am\nt ( physical assi/ance1 z 9 ! case ( a sick :ale :o may be support$ by its fell[s 9 ! wat] 9 ord] to brea!4 ,b only we h develop$ m$ic9e1 & we h m rec5tly begun to develop ways to treat problems t affect our emotions1 attitudes1 & behavior4 ,:5 individuals1 p]haps in/9ctively1 di/ance !mselves f o!rs & bottle up _! malaise1 !y turn _! backs on ! educat$ assi/ance & goodwill t are available4 ,sometimes we d s out ( fe> ( treatm5t c\pl$ ) fe> ( admitt+ t we are n z self-suffici5t z we want to believe4 ,b m (t5 9 ! case ( problems t directly affect our moods--i4e41 psy*ological problems--we feel a%am$ & afraid ( ! /igma1 ! disgrace1 t our society atta*es to ^? :o admit !y h unhappy or confus$ feel+s4 ,!re c be little d\bt t society is unbalanc$ 9 legitimat+ physical sickness :ile react+ ) al>m & repugnance to problems ( a psy*ological nature4 ,?9k ( ! discrim9ation aga9/ psy*ological disord]s1 9 favor ( physical compla9ts1 practic$ op5ly by ne>ly all heal? insurance companies1 (f]+ r$uc$ b5efits = m5tal heal?4 ,psy*ological pa9 does n hurt any less because x is emotionally bas$4 ,ev5 s1 emotional di/ress is held suspect1 & insurance cov]age = x1 if n rul$ out completely1 is frequ5tly only p>tial4 ,x 01 aft] all1 n m ?an a c5tury ago t our m5tal hospitals 7 run ) an inhumanity t #ae /ill c s5d %iv]s d[n "o's sp9e4 ,unhappily1 x is cle> t we h n entirely left ?is phase ( our developm5t3 ! film ,"o ,flew ov] ! ,cuckoo's ,ne/1 = example1 po9ts to cont9u+ inhumanity 9 "s psy*iatric hospitals4 ,& !re is ! alleg$ case ( a ,ukra9ian woman :o 0 involunt>ily committ$ & held = "s ?irty ye>s 9 a m5tal hospital4 ,%e 0 ?\ght to be insane because1 un=tunately1 no "o involv$ 9 h] case recogniz$ h] gibb]i% z ,ukra9ian6 ,emotional & m5tal problems are /ill n accept$ by _m4 ,!re is a fe> ( ! unkn[n & a skepticism t psy*ological problems are no?+ m ?an signs t a p]son is mal+]+1 simply does n want to try to get bett]4 ,& !re is a gut-level anxiety :5 confront$ by someone :o1 we worry1 may be close to go+ ov] ! edge4 ,,te>+ ,,d[n ,,prison ,,walls ,:at undue h>d%ip ?is causes6 ,z wond]ful z ! body is1 we accept its imp]fections1 its susceptibility to disease & injury4 ,b our bra9s1 our m9ds1 our spiritual dim5sion--h[ less well we und]/& ^! 9 _! great] complexity6 ,is x s /range & unacceptable t !y %\ld be prone to _! own problems1 t !y1 too1 may br+ suff]+8 ,because society does n legitimate emotional pa91 _m p are n able to see _! own pa9 z legitimate4 ,s !y d5y x1 to !mselves & to o!rs4 ,b pa9 is usually a heal?y signal2 x tells y t some?+ is wrong3 ,)draw y\r h& f ! fire6 ,move y\r cramp+ legs6 ,d some?+ ab\t y\r abusive1 alcoholic husb&6 ,get help = y\r depression6 ,e "o ( ^! pa9s is a w>n+4 ,to ignore all except ^? t are physical w\ld be l say+ t we are only bodies1 )\t feel+s1 )\t humanity4 ,:5 y are 9 pa91 :atev] its s\rce & k9d1 pay att5tion to x6 ,pa9 is (t5 :at po9ts to a bett] life4 ,x is surely bett] to cope ) a label appli$ 9 ignorance by "s memb]s ( society1 if ?is mu/ be1 ?an to live an unsatisfy+ & pa9ful life4 ,y mu/ n manage y\r life j to avoid ! pot5tially critical judgm5t ( p :o are ignorant (1 or :o refuse to ackn[l$ge1 ! realities ( human psy*ology4 ,y c feel sure t among well-in=m$ p1 if y h _h to deal ) alcoholism1 drug abuse1 a difficult #af m>riage1 job depression1 or any o!r psy*ological problem1 y w be ?\ght to be j z respectable z if y _h cop$ ) major surg]y aft] an automobile accid5t4 ,9 fact1 s9ce ov]com+ a psy*ological difficulty dem&s a great deal m ( y\r own volunt>y ef=t1 com+ up a w9n] w increase y\r own self-respect & ! respect1 & ev5 admiration1 ( ^? ^: judgm5t is mean+ful4 ,! fir/ /ep to fre$om f pa9 is to become aw>e ( ! walls ( ! prison t %ut y 94 ,only !n c y beg9 to te> !m d[n4 #ag #b ,,pa?s ,,to ,,help ,to wr5* any?+ out ( its accu/om$ c\rse takes en]gy1 ef=t & pa94 ,x does great viol5ce to ! exi/+ patt]n4 ,_m p want *ange1 bo? 9 ! ext]nal _w & 9 _! own int]nal _w1 b !y are unwill+ to und]go ! sev]e pa9 t mu/ prec$e x4 ,riv]s 9 extremely cold climates freeze ov] 9 w9t]4 ,9 ! spr+1 :5 !y ?aw1 ! s\nd ( ice crack+ is an incr$ibly viol5t s\nd4 ,! m ext5sive & sev]e ! freeze1 ! m ?und]\s ! ?aw4 ,yet1 at ! end ( ! crack+1 break+1 viol5t p]iod1 ! riv] is op51 life-giv+1 life-c>ry+4 ,no "o says1 ,let's n suff] ! ?aw2 let's keep ! freeze2 ev]y?+ is quiet n[4 ,m>y ,e4 ,mebane1 ,m>y1 ,wayf>] ,if y decide to ent] !rapy1 y\r !rapi/ w probably ask y to ?9k ab\t two int]relat$ que/ions 7!y may be express$ 9 a v>iety ( ways73 ,:]e are y n[8 & ,:]e d y want to g8 ,y\r !rapi/ or c\nselor w1 z he comes to "k y1 (t5 be able to help y to answ] ^! by %>+ 8 p]ceptions ( y4 ,"o ( ! ma9 tasks ( ! c\nsel+ process is to help a p]son ga9 improv$ self-und]/&+ t embraces bo? pres5t problems & future goals4 #ah ,yet if y c ga9 a c]ta9 measure ( self-und]/&+ & self-direction be=e ent]+ c\nsel+ or !rapy1 x w be easi] = y to *oose an approa* to c\nsel+ or !rapy t m closely fits y\r problems1 values1 objectives1 available "t1 & ev5 y\r f9ancial ne$s4 ,y %\ld f9d 9 ?is book a basis = prelim9>y self-c\nsel+ t w give y a s5se ( h[ & :]e be/ to beg9 !rapy4 ,x is important to recognize t none ( u ev] rea*es a f9al /ate ( self-k3 z long z we live1 our self-und]/&+ is capable ( gr[+4 ,:at we really und]/& ab\t ourselves & :at we believe ourselves to ne$ & want are nev] m ?an provisional1 t5tative4 ,additional exp]i5ce1 j ! fact ( liv+ long]1 v likely w lead y to p]ceive y\rself diff]5tly & motivate y to modify y\r priorities & *ange y\r goals4 ,,:]e ,,are ,,y ,,n[8 ,late 9 #aihd1 ! ,national ,in/itute ( ,m5tal ,heal? releas$ ! fir/ publi%$ results ( ! l>ge/ m5tal heal? survey ev] conduct$4 ,! results are />tl+ & are an unhappy comm5t>y on our society & _w4 ,! report %[s t #bj p]c5t ( ,am]icans suff] f psy*iatric disord]s4 ,yet only "o 9 five ( ^! seeks help4 ,! o!rs live ) _! suff]+4 ,! mo/ common problems are ^!3 ,millions ( ,am]icans ,psy*iatric ,"n ( ,condition ) ,?is ,disord] ,anxiety disord]s #ac4a ,phobias #aa4a ,sub/ance abuse 7alcohol1 drugs1 etc47 #aj4j ,affective disord]s 7includ+ depression & manic depression7 #i4d ,obsessive-compulsive disord]s #b4d ,cognitive impairm5t #a4f ,s*izophr5ia #a4e ,antisocial p]sonality #a4d ,! ,,nimh /udy also %[s t wom5 are twice z likely to seek help z m54 ,two int]relat$ inf]5ces are commonly made f ?is previ\sly kn[n fact3 wom5 are (t5 m accept+ ( _! emotional /ate 7m5 9 our society are taught to disreg>d _! feel+s1 "p ( ma*ismo71 & wom5 are less will+ to all[ pride to /& 9 _! way ( gett+ help 7wom5 are less affect$ by ! my? ( self-suffici5cy74 #ai ,! ,,nimh report indicates1 too1 t ! incid5ce ( psy*ological problems drops by approximately half aft] ! age ( =ty-five4 ,! bel[-=ty-five ye>s are usually ^? ( highe/ /ress4 ,above =ty-five1 individuals t5d to become psy*ologically bett] integrat$4 ,?is probably reflects increas$ maturity & a m accept+1 calm] attitude t[>d life4 ,! l[e/ rate ( emotional di/urbance appe>s to be 9 p ov] sixty-five4 ,yet !re are _m ?\s&s ( individuals ov] =ty-five1 & inde$ ov] sixty-five1 = :om life rema9s a difficult inn] /ruggle4 ,! /ati/ics f ! ,,nimh /udy reveal h[ v wide-spread p]sonal psy*ological difficulties are4 ,giv5 ! degree ( complexity ( our m5tal1 emotional1 & spiritual makeup1 ?is %\ld be und]/&able1 especially :5 we take into acc\nt tw5tie?-c5tury /resses t we> u d[n4 ,caught up z mo/ ( u are 9 our jobs1 families1 & daily worries1 we are unaw>e t1 9 a v real s5se1 m5tal & emotional heal? problems h assum$ epidemic proportions4 ,if y be> 9 m9d h[ fe>ful our society enc\rages u to be ( admitt+ su* difficulties1 y c p]haps imag9e h[ sub/antial ! iceb]g ( psy*ological suff]+ is3 mo/ ( x lies bel[ ! wat]l9e ( public consci\sness4 ,! ,,nimh /udy results %\ld enc\rage y1 if y suff] f p]sonal emotional difficulties1 to realize t y are n alone 9 ! problems y face4 ,kn[+ t !re are _m good & f9e individuals ) v likely simil> problems may urge y to take an hone/ look at :]e y are n[ & !n to try to decide :at *anges may be helpful to y3 :]e y want to g f "h4 ,if y are =tunate1 y may already be aw>e ( ! ma9 ?+s 9 y & 9 y\r life t br+ y di/ress4 ,if s1 y are "o /ep clos] to be+ able to d some?+ ab\t !m4 ,_m ( u1 h[ev]1 h become s clev] & effective 9 d5y+ :at we really feel t we h lo/ t\* ) our true selves4 #bj ,desires to repair an unhappy m>riage are %elv$ :ile ! *ildr5 are gr[+ up2 ! unrew>d+ nature ( a job is ignor$ because priority is giv5 to f9ancial security2 y may be unable or unwill+ to face ! pa9 y br+ to y\rself & o!rs z a result ( a drug- or alcohol-abuse habit4 ,9 mo/ cases1 x is n possible to ga9 ! motivation & means to solve a problem until y are will+ to accept t !re is a problem t ne$s to be solv$4 ,because ( ! bl9d+ nature ( ! habits y may h e/abli%$1 & because ( y\r def5sive desires to disreg>d :at di/urbs ! equilibrium ( habit1 x may be h>d to acquire a cle> picture ( :]e y /& "r n[4 ,sometimes x c be useful to *eck ) o!rs3 h[ d !y see y8 ,a close fri5d ( m9e1 aft] ye>s 9 h] pr(ession1 began r sudd5ly to feel h[ unrew>d+ h] job 01 & %e began to suspect t %e may h hidd5 ^! feel+s = a long "t4 ,%e _h ma9ta9$ a regul>1 almo/ once-a-week ex*ange ( lett]s ) h] "m = twelve ye>s4 ,%e knew t h] "m kept h] lett]s1 s %e w5t to visit h] & ask$ if %e might skim ?r\gh !m1 pay+ att5tion to comm5ts %e _h made ov] ! ye>s ab\t h] "w4 ,x quickly became cle> to h] t1 consi/5tly1 %e _h _h only v negative ?+s to say ab\t h] job4 ,aft] skimm+ ?r\gh doz5s ( lett]s writt5 ov] a p]iod ( ye>s1 %e became conv9c$ ( h] real & endur+ feel+s & *ang$ h] l9e ( "w4 ,su* self-k does n usually come ?is easily4 ,we may pride ourselves on hone/y1 b !re are few ( u :o p]mit ourselves self-hone/y to any real degree4 ,exi/5tial-humani/ic psy*ologi/s h paid mu* att5tion to ^! ways t we live 9 bad fai?--ea* ( u try+ to be a p]son he or %e really is n & d5y+ ! p]son he or %e really is4 ,we live 9 a society t emphasizes con=mity1 be+ somebody1 ga9+ /atus & weal? & a good position--yet ^! values may n co9cide ) be+ true to ourselves4 ,p>5tal influ5ces c be /rong1 z c expectations f our sp\ses4 ,we int]nalize _m ( ^! values s t x becomes difficult to see :o we really are & :at we really want f life & f our ef=ts4 ,!re are no easy r\tes to self-realization4 ,we mu/ all d a c]ta9 am\nt ( hunt+ 9 ! d>k--or1 z a colleague ( m9e #ba likes to say1 scrabbl+ ab\t--= a s5se ( real id5tity4 ,recogniz+ t y\r self-und]/&+ is probably always imp]fect does n mean t x is ( little value4 ,x is1 9 ! end1 all any ( u has to g on4 ,x may be useful to ask p close to y :at !y p]ceive ab\t y4 ,read+ ?r\gh a gr\p ( old lett]s1 keep+ a j\rnal1 or simply sett+ aside a few m9utes = self-appraisal at ! end ( ea* day or week may also be enlight5+4 ,if y d ?is self-exam9ation1 gradually :]e y are & :at y feel w become cle>]1 & !n x w be natural & appropriate to ask :at ! next /ep is4 ,,:]e ,,d ,,y ,,want ,,to ,,g8 ,,:at ,,k9d ,,( ,,p]son ,,d ,,y ,,want ,,to ,,become8 ,influ5ces f society1 y\r p>5ts1 y\r sp\se1 or y\r close fri5ds make x difficult = y to "k y\rself4 ,def5sive habits & fe> ( *ange also /& 9 ! way4 ,^! are significant blocks to self-und]/&+4 ,:5 y turn y\r att5tion to ! future1 to :at k9d ( p]son y want to become1 y w enc\nt] m blocks to ov]come4 ,life is l t6 ,x seems t few ?+s come )\t ef=t & p]sev]ance4 ,!re are two major ob/acles to design+ ! model ( ! p]son y w\ld l to become4 ,because !y c be s important1 ,i want to introduce !m e>ly 9 ?is book4 ,!y are blame & guilt1 & !y are l ! two ends ( a seesaw4 ,:5 we appraise :at we h done 9 our lives1 we usually f9d reasons to blame o!rs1 or p]haps to blame limit$ educational opportunities1 or social pressures1 or discrim9ation--9 %ort1 our pa/ environm5t3 all ! factors t limit$ our lives1 int]f]$ ) ! atta9m5t ( our hopes1 & 7 n "u our control4 ,on ! o!r end ( ! seesaw sits guilt4 ,& guilt is really blame turn$ inw>d4 ,if we try to p9po9t ! factors t h be5 responsible = our lives n hav+ turn$ out bett]1 we t5d to blame environm5tal limitations1 or else we feel guilt = :at we see z our own fail+s4 ,usually1 we locate responsibility 9 bo? areas4 ,mo/ ( u1 h[ev]1 h unbalanc$ seesaws4 ,we usually #bb blame ?+s outside ourselves = our disappo9tm5ts4 ,do+ s is a habit t all[s u to avoid responsibility = ourselves &1 9 turn1 limits our future developm5t4 ,on ! o!r h&1 "s ( u blame ourselves mu* too readily3 we c>ry an exagg]at$ burd5 ( responsibility1 :i* weighs u d[n & also limits our gr[? z individuals4 ,ideally1 psy*o!rapy w\ld l u to let g ( s-call$ pa/ negative condition+--blame z well z guilt--s t we are free to *oose :o we are & w become4 ,ev5 ?\gh ?is is c]ta9ly a desirable attitude1 mo/ ( u _c really =get & let g4 ,we are all inh]itors ( a t5aci\s pa/3 ! influ5ces ( pa/ ev5ts h a c]ta9 p[] ov] u1 & we mu/ ei!r resign ourselves to be+ controll$ by ! pa/ or fight its influ5ce4 ,! attitude we take t[>d ! pa/ w usually affect h[ we meet ! future1 (t5 dim9i%+ our fre$om to *ange old habits & und]m9+ our hope & fai? 9 ourselves4 ,= example1 if ,jeff blames 8 limitations today on 8 p>5ts1 on ! ways !y influ5c$ him1 he may set goals = himself t are f> f be+ freely *os54 ,jeff may *oose !m 9 reaction to dom9ation by 8 p>5ts ye>s ago4 ,8 p>5ts may h tri$ to influ5ce him to be a g5tle1 c\rte\s p]son ) arti/ic int]e/s4 ,b z a result ( o!r pa/ influ5ces--= example1 because ( frequ5t moves ( ! family & repeat$ly be+ bulli$ z ! new kid at diff]5t s*ools--,jeff may feel ho/ile t[>d o!rs1 s 79 reaction to 8 p>5ts' influ5ce & because ( p5t-up ho/ility7 he decides to g into sci5ce 7r ?an art1 = :i* he p]haps has a tal5t7 & rejects g5tle1 c\rte\s qualities 9 himself4 ,x is difficult to *oose freely4 ,"s psy*ologi/s d n believe x actually is possible4 ,& yet1 :e!r we are ev] truly free or n1 we /ill try to plan our lives1 & we believe our plans 7& frequ5tly ! lack ( !m7 h some?+ to d ) :at we make ( liv+4 ,mo/ p :o ent] c\nsel+ or psy*o!rapy want to improve "s aspect ( _! liv+4 ,individuals ^: seesaw is weight$ on ! side ( blam+ outside influ5ces too (t5 come to feel x is too mu* "w & quit !rapy because !y _c accept ! ne$ to make *oices & decisions 9 spite ( pa/ influ5ces4 ,on ! o!r h&1 p :o blame #bc !mselves may be s guilt-ridd5 t !y are impair$ 9 _! op5ness to ! future & feel unable to initiate fundam5tal *anges 9 _! lives4 ,:5 y ask y\rself1 ,:at k9d ( p]son d ,i want to become81 try to be aw>e ( ! ext5t t y\r answ] may be weigh$ d[n by feel+s ( blame & guilt4 ,all too (t5 we cont9ue to p]petuate1 unkn[+ly1 ! same old unsatisfy+ patt]ns because we are trapp$ by our habits ( blam+ o!rs or ourselves4 ,if y feel bogg$ d[n by feel+s ( guilt or burd5$ by ! limitations ( an unfair pa/1 x may be difficult = y to develop a freely *os5 s5se ( direction4 ,b p]haps y w be able to ackn[l$ge t ! guilt or blame y feel is an ob/acle to be ov]come4 ,if s1 y h def9$ an objective t y may use to decide :at type ( c\nsel+ or !rapy may be a mo/ promis+ fir/ /ep4 ,:at ,i am sugge/+ is t an ob/acle t makes x h>d = y to ga9 a s5se ( direction c itself po9t y 9 a direction4 ,if !re are blocks1 x c be helpful to meet !m head-on4 ,9 !rapy1 ! phrase work+ ?r\gh a problem (t5 means exactly ?is4 ,*oos+ :at k9d ( p]son y wi% to be is a process1 n an ev5t4 ,x is n some?+ t happ5s & !n is ov]4 ,*oice is some?+ implicit 9 ea* day ( y\r life2 sometimes x is q consci\s1 b x is (t5 dull$ by ! unconsci\sness ( habit4 ,y\r p]sonal goals may und]go gradual or abrupt *ange4 ,psy*ological gr[? is y\r response to ^! *anges 9 outlook4 ,,:at ,,does ,,!rapy ,,try ,,to ,,d8 ,individual !rapy or c\nsel+ 7!rapy = gr\ps & families w be discuss$ 9 detail lat]7 is really an attempt to build a bridge betwe5 answ]s to ^! two n[ famili> que/ions3 ,:]e are y n[1 or :at k9d ( p]son are y n[8 & ,:]e d y want to g1 or :at k9d ( p]son d y want to become8 ,?9k ( !rapy z an attempt to build a bridge s t y c pass f a pres5t situation to a desir$ way ( be+4 ,c>l ,rog]s def9es !rapy z a relation%ip 9 :i* at lea/ #bd "o ( ! p>ties has ! int5t ( promot+ ! gr[?1 developm5t1 maturity1 improv$ function+1 improv$ cop+ ) life ( ! o!r4#a #a ,c>l ,rog]s1 ,on ,becom+ a ,p]son3 ,a ,!rapi/'s ,view ( ,psy*o!rapy 7,new ,york3 ,h\ghton ,miffl91 #aifa71 pp4 #ci-dj4 ,psy*iatri/ ,all5 ,:eelis takes ?is def9ition fur!r3 ,!rapy may (f] insights into bewild]+ exp]i5ce1 help ) ! mak+ ( connections1 give com=t & enc\ragem5t1 assi/ 9 ! always slipp]y decision ( :e!r to hang on & try h>d] or to look = a diff]5t way to try4444 ,! place ( insight is to illum9e3 to asc]ta9 :]e "o is1 h[ "o got !re1 h[ n[ to proce$1 & to :at end4 ,x is a bluepr9t1 z 9 build+ a h\se1 & may be ess5tial1 b no "o a*ieves a h\se by bluepr9ts alone1 no matt] h[ accurate or detail$4 ,a "t comes :5 "o mu/ take up hamm] & nails4444#b #b ,all5 ,:eelis1 ,h[ ,p ,*ange 7,new ,york3 ,h>p] & ,r[1 #aigc71 pp4 #aja1 #ajg4 ,!rapy involves a ?ree-fold relation%ip among a help+ pr(essional1 ! approa* to !rapy us$ by him or h]1 &1 :at is mo/ important1 ! outlook ( ! individual cli5t4 ,9 ?is book we w exam9e ea* ( ^! ?ree dim5sions ( !rapy 9 "s detail1 b "h we w conc5trate on ! "o !rapi/s g5]ally agree is ! mo/ important3 y--! k9d ( p]son y are1 :at y\r attitudes & outlook are1 &1 ( c\rse1 h[ mu* y really want to develop or *ange4 ,y\r attitudes w det]m9e1 probably m ?an any?+ else1 :at v>iety ( !rapy y w mo/ b5efit f4 ,!rapi/s1 l tea*]s 7:i* !y really are71 f9d t _! cli5ts or pati5ts c be divid$ into two gr\ps3 active & passive le>n]s4 ,:5 y g to a doctor ) a brok5 arm1 y\r relation%ip to y\r doctor is a passive "o3 y ne$ only to coop]ate z he exam9es y\r arm1 p]haps adm9i/]s an ane/hetic1 & sets ! break4 ,y may take m$ication = pa91 & !n y simply wait until1 ?anks to ! body's automatic heal+ processes1 ! break is fus$4 ,! public's conception ( m$ic9e is pr$om9ately a passive "o4 ,to be a pati5t is = ! mo/ "p to be a passive by/&]3 ! physician is ! active ag5t :o br+s ab\t heal+4 ,!re are occasional #be exceptions--= example1 physical !rapy & rehabilitation !rapy aft] a s]i\s injury or illness1 :5 ! pati5t mu/ become m active & accept m responsibility4 ,z we w see1 a few approa*es to c\nsel+ & psy*o!rapy pres]ve1 to "s ext5t1 ! traditionally passive role ( ! pati5t4 ,mo/ ( !m1 h[ev]1 require a good deal ( initiative & j pla9 h>d "w on ! "p ( ! pati5t or cli5t4 ,9 build+ ! h\se ( "o's life or 9 its remodel+1 "o may delegate no?+2 = ! task c be done1 if at all1 only 9 ! work%op ( "o's own m9d & he>t1 9 ! mo/ intimate rooms ( ?9k+ & feel+ :]e none b "o's self has fre$om ( movem5t or compet5ce or au?ority4 ,! responsibility lies ) him :o suff]s1 orig9ates ) him1 rema9s ) him to ! end4 ,x w be no less 8 if he enli/s ! aid ( a !rapi/2 we are no m ! product ( our !rapi/ ?an ( our g5es2 we create ourselves4 ,! sequ5ce is suff]+1 insight1 w1 action1 *ange4 ,! "o :o suff]s1 :o wants to *ange1 mu/ be> responsibility all ! way4 ,mu/ because s soon z responsibility is ascrib$ outside oneself ! =ces resi/+ *ange occupy ! :ole ( "o's be+1 & ! process ( *ange comes to a halt4 ,a psy*iatri/ may help1 p]haps crucially1 b 8 be/ help w be ( no avail if he is requir$ to provide a degree ( insight :i* w ( itself a*ieve *ange4#c #c ,:eelis1 ,h[ ,p ,*ange1 pp4 #aja-ajb4 ,,:y ,,is ,,x ,,s ,,complicat$8 ,= bett] or = worse1 human nature is a _m-spl5dor$ ?+4 ,x doesn't take an advanc$ degree 9 psy*o!rapy to "k t p c h _m diff]5t k9ds ( p]sonal problems4 ,?is fact1 if we appreciate x fully1 makes m und]/&able :y !re are s _m alt]native approa*es to help+ p ) _! difficulties4 ,9 ! _w ( !ory1 a model is a simplifi$ repres5tation ( reality4 ,y\r *eck+ acc\nt record is a model1 9 j ?is s5se1 ( h[ _m real doll>s & c5ts y h 9 ! bank4 ,"h is a mu* simplifi$ model t repres5ts five ma9 psy*ological1 emotion-lad5 dim5sions ( a p]son3 #bf ,illu/ration3 ,five ma9 psy*ological dim5sions ( a p]son3 feel+s1 hopes1 abilities1 relation%ips ) o!rs1 & behavior ,we see "r away t1 = ! same reasons t !re are specialties 9 m$ic9e--e4g41 or?op$y = bones1 neurology = n]ves1 d5ti/ry = tee?--!re %\ld be special approa*es t focus on diff]5t psy*ological dim5sions ( ! p]son4 ,some?+ else y may see is t ! five dim5sions 9 ! model are n isolat$ f "o ano!r4 ,!y int]relate & ov]lap a good deal4 ,j z a d5ti/ mu/ "k ab\t ! or?op$y ( ! jaw & skull & ! neurology ( ! tee? a neurologi/ & an or?op$i/ are expect$ to "k some?+1 ?\gh n 9 great detail1 ab\t d5tition4 ,ea* ( u is a unity ( :at all ! m$ical & psy*ological specialties /udy 9 diff]5t ways1 plus a good deal m1 z arti/s1 writ]s1 !ologians1 & musicians make evid5t4 ,t m ?an #acj di/+ui%able !rapies h n[ be5 develop$ may p]haps /rike u1 ev5 s1 z excessive4 ,b ef=ts are be+ made to unify _m ( ^! approa*es1 & ?is book is "o ( !m4 ,r ?an talk+ ab\t #acj diff]5t approa*es1 we w c5t] our att5tion on ! ma9 categories into :i* ! _m approa*es c be sort$4 ,"o ( ! int]e/+ & hopeful ?+s t c be said #bg ab\t ! multiplicity ( approa*es to !rapy & c\nsel+ is t treatm5t by any "o ( !m c (t5 be ( "s help4 ,= example1 ,hel5 may wi% to /op dr9k+ 7a habit 9 ! behavior category71 & %e may be help$ by means ( behavior modification4 ,%e may !n f9d t1 z a direct result1 h] self-concept 7feel+ category7 has gr[n /rong]1 :ile h] m>riage 7relation%ip category7 has also improv$4 ,or1 ,ralph may g to a vocational c\nselor :o helps him def9e a direction 7hope category7 9 keep+ ) 8 int]e/s & aptitudes4 ,ralph goes back to s*ool & develops a backgr\nd 7abilities category7 t reflects ^! aptitudes & int]e/s4 ,! s5se ( direction he has ga9$ helps ,ralph /op us+ drugs 7behavior71 r$uces 8 ho/ility & anxiety 7feel+s71 & improves 8 relation%ips ) o!rs4 ,9 o!r words1 a helpful *ange 9 "o direction c (t5 lead to noticeable *anges 9 o!rs4 ,h[ev]1 !re also are risks t we %\ld n ignore3 ,sue goes to an analy/ & le>ns ov] a p]iod ( mon?s t h] m>riage to ,fr$ 0 bas$ on a s5se ( inadequacy ,sue le>n$ dur+ h] *ildhood4 ,h] fa!r 0 s highly controll+ & critical ( h] t %e 0 nev] able to develop a s5se ( h] own value4 ,h] husb&1 ,fr$1 is also dom9e]+ & au?orit>ian1 & he abuses ,sue frequ5tly1 usually mi/reat+ h] ?r\gh criticism1 b he has sometimes also beat5 h] physically4 ,sue has accept$ ?is )\t "q = a long "t1 b due to ! emotional support receiv$ f h] analy/1 %e is beg9n+ to develop a s5se ( self-e/eem4 ,z h] self-e/eem gr[s1 %e comes to realize t h] m>riage is a self-de/ructive relation%ip & decides to divorce ,fr$4 ,h] !rapy has be5 helpful to ,sue1 b x has1 indirectly1 result$ 9 a breakd[n ( h] admitt$ly unhappy m>riage4 ,a *ange 9 "o dim5sion c sometimes lead to an initially un9t5d$ *ange 9 ano!r area4 ,,if ,,x ,,hurts1 ,,don',t ,,procra/9ate6 ,"o ( ! m>vel\s ?+s ab\t human nature is ! ability to feel pa94 ,?is may seem l an odd ?+ to say1 b reflect = a mom5t4 ,pa9 is frequ5tly :at spurs u on f an unsatisfy+ & ev5 de/ructive situation to a bett] future4 ,pa9 tells y to j]k y\r h& away f a hot /ove4 ,a diff]5t k9d ( pa9 tells y x is "t to get on ) liv+1 "t to #bh initiate "s positive *anges4 ,anxiety1 sleeplessness1 irritability1 res5tm5t1 depression--!y all c be pa9ful inn] feel+s t tell u t all is n well 9 our inn] selves4 ,x is well-kn[n to c\nselors & !rapi/s t1 9 g5]al1 ! long] ^! signs ( ne$ are ignor$1 ! long] x may take to help a p]son resolve ! difficulties t h be5 press+ = att5tion4 ,di/ress is n easily buri$4 ,:5 suppress$1 x t5ds to pop up aga9 lat]1 sometimes ) increas$ sev]ity4 ,we c1 ironically1 *oose to be /rong & ignore ^! messages f )91 or we c li/5 to our feel+s1 pay att5tion to our hopes1 develop ne$$ abilities1 seek to improve our relation%ips ) o!rs1 & "w to *ange "s ways we behave t block our happ9ess4 ,problems t conc]n y\r inn] well-be+ & ! heal? ( y\r relation%ips ) o!rs :o are important to y are bett] resolv$ ?an buri$1 & ! e>li] !y are giv5 ! att5tion !y des]ve1 ! easi] y\r pa? ?r\gh *ange to a bett] life w be4 #bi #c ,,bridges ,,f ,,"h ,,to ,,!re ,,an ,,ov]view ,,( ,,! ,,field ,,( ,,!rapy ,,! ,,help+ ,,pr(essional ,pr(essionals 9 ! fields ( c\nsel+ & psy*o!rapy h a wide range ( diff]5t backgr\nds & p]spectives4 ,!y c be brok5 d[n into ^! categories3 ,social "w c\nselors3 c\nselors = individuals2 m>riage & family c\nselors2 gr\p c\nselors2 & vocational guidance c\nselors ,psy*ologi/s3 cl9ical psy*ologi/s2 c\nsel+ psy*ologi/s2 & psy*ometri/s ,psy*iatri/s ,o!r !rapi/s3 religi\s c\nselors2 bi(e$back !rapi/s2 hypno!rapi/s2 relaxation & m$itation in/ructors2 holi/ic !rapi/s su* z bio5]getics !rapi/s1 yoga in/ructors1 & ex]cise !rapi/s2 etc4 ,! education1 sup]vis$ tra9+1 & outlooks ( ^! pr(essionals v>y greatly1 z d _! fees & ! av]age l5g? ( "t !rapy c be expect$ to la/4 ,we w look m closely at ^! diff]5ces lat] on4 #cj ,,! ,,range ,,( ,,approa*es ,,to ,,!rapy ,because ( _! diff]5ces 9 tra9+ & p]sonal or !oretical pref]5ces1 ! di/9ct classes ( !rapi/s repres5t a div]sity ( approa*es to !rapy4 ,!re are num]\s s*ools ( psy*oanalysis1 psy*o!rapy1 behavioral !rapy1 gr\p !rapy1 & m>riage & family !rapy1 & a range ( approa*es to p]sonal adju/m5t1 includ+ ex]cise !rapies1 relaxation te*niques1 =ms ( m$itation1 & drug & nutrition !rapies4 ,f any "o ( ^!1 a multitude ( s*ools ( ?\ght bran*es out4 ,= example1 psy*oanalysis has1 s9ce ,freud1 develop$ along a numb] ( diff]5t l9es3 ea* major psy*oanaly/ has =mulat$ 8 or h] own approa* to analysis t di/+ui%es itself f ,freud's4 ,psy*o!rapy1 to take ano!r example1 is n a s+le approa* to !rapy1 b r makes up an entire field4 ,x is ! l>ge/ & mo/ rapidly gr[+ area relat+ to m5tal heal?4 ,9 x are includ$ di/9ct approa*es1 su* z cli5t-c5t]$ !rapy1 ,ge/alt !rapy1 transactional analysis1 rational-emotive !rapy1 exi/5tial-humani/ic !rapy1 reality !rapy1 logo!rapy1 ,adl]ian !rapy1 emotional flood+ !rapies1 & direct decision !rapy4 ,9 lat] *apt]s1 we w look at ^! approa*es to psy*o!rapy m closely4 ,! goal ?r\gh\t ?is book w be to enable y to und]/& en\gh ab\t ea* ( ! major !rapies to make an in=m$ decision 9 *oos+ an approa* 7& !re may be m ?an "o7 t w be mo/ useful 9 relation to y\r own und]/&+ ( y\r objectives1 :e!r !y are long-range or focus$ on ! ne$ to elim9ate imm$iate ob/acles to gr[?4 ,,! ,,diff]5ce ,,betwe5 ,,c\nsel+ ,,& ,,psy*o!rapy ,c\nsel+ & psy*o!rapy h develop$ a great deal 9 rec5t ye>s--s mu* s t _! b\nd>ies h (t5 ov]lapp$4 ,cle>-cut di/9ctions betwe5 ! two fields are increas+ly h>d to draw4 ,nev]!less1 "s pr(essionals pref] to call !mselves by "o "n & "s by ! o!r4 ,9 g5]al t]ms1 c\nsel+ t5ds to be a %ort-t]m process ! purpose ( :i* is to help ! cli5t1 c\ple1 or family #ca ov]come specific problems & elim9ate blocks to gr[?4 ,c\nsel+ gives individuals a *ance to resolve p]sonal problems & conc]ns4 ,mo/ c\nselors attempt to help _! cli5ts become aw>e ( a wid5$ range ( possibilities ( *oice2 f ?is p]spective1 c\nsel+ tries to free cli5ts f rigid patt]ns ( habit4 ,habits c be useful1 b !y c also int]f]e ) life4 ,! te*nical habits ( a piani/1 = example1 are ess5tial 9 p]=mance4 ,simil>ly1 only :5 language skills become habitual does a speak] ( a =eign language a*ieve comm& ( x4 ,on ! o!r h&1 fe>s c also become habitual1 & !y may come to int]f]e ) ev]yday activities4 ,anxiety ov] public speak+ may become habitual4 ,!re are _m p]sonally de/ructive habits--alcoholism1 smok+1 ov]- or "u-eat+1 abusive behavior1 %yness & social )drawal--& all c become self-p]petuat+ patt]ns4 ,c\nsel+ c help p break out ( ^! habits1 (t5 9 "p by help+ cli5ts become aw>e ( unrecogniz$ alt]natives4 ,psy*o!rapy t5ds to be m conc]n$ ?an c\nsel+ ) fundam5tal p]sonality-/ructure *anges4 ,frequ5tly1 psy*o!rapy is a long]-t]m process4 ,frequ5tly1 too1 ! problems treat$ 9 psy*o!rapy are h>d to p9 d[n & are less specific4 ,!y include *ronic depression1 p]vasive 7free-float+7 anxiety1 g5]aliz$ lack ( self-e/eem1 & s on4 ,su* difficulties are n well def9$2 _! causes may be vague or unc]ta91 & (t5 mu* "t mu/ be sp5t to get at _! basis4 ,psy*o!rapy seeks to br+ ab\t an int5sive self-aw>5ess ( ! inn] dynamics--! int]nal =ces & ! pr9ciples t gov]n !m--t are involv$ 9 *ronic =ms ( p]sonal di/ress4 ,sometimes1 z 9 analytical psy*o!rapy or psy*oanalysis1 att5tion is focus$ on ! role ( unconsci\s processes 9 inn] conflicts2 treatm5t attempts to resolve ^! conflicts by und]/&+ ! unconsci\s =ces involv$4 ,! t]m psy*o!rapy is (t5 us$ to imply m advanc$ pr(essional tra9+1 :]eas c\nsel+ is some?+ individuals ) m mode/ academic cr$5tials may practice4 ,:e!r a pr(essional is call$ a c\nselor or a !rapi/ has to d ) 8 or h] level ( tra9+1 ) ! sett+ 9 :i* s]vices are (f]$1 &1 to a c]ta9 degree1 ) t p]son's !oretical ori5tation4 #cb ,9 practice1 ^! diff]5ces 9 outlook frequ5tly am\nt to diff]5ces 9 emphasis r ?an approa*4 ,9 ?is book1 ,i w speak ( c\nsel+ & psy*o!rapy int]*angeably unless !re is a ne$ to be especially re/rictive4 ,,!rapy3 ,,! ,,art ,,( ,,*ange ,,h[ ,,we ,,are ,,able ,,to ,,*ange ,we are :at we d 444 & may d :at we *oose4 ,all5 ,:eelis1 ,h[ ,p ,*ange ,freud id5tifi$ five causes ( p]sonality developm5t3 99 gr[? & maturation 99 fru/ration 99 conflict 99 inadequacy 99 anxiety ,by ! "t we become adults1 mo/ ( u h develop$ sets ( def5ses to enable u to cope ) ev]yday problems 9 spite ( feel+s ( fru/ration1 conflict1 inadequacy1 & anxiety4 ,b z ^! feel+s become m pron\nc$1 :5 we enc\nt] situations t int5sify ^! feel+s1 we mu/ put m & m en]gy into our def5ses4 ,!y all[ u to cont9ue liv+ & act+ 9 habitual ways1 usually by hid+1 by d5y+1 & sometimes by di/ort+ our p]ceptions ( reality4 ,fac+ ! inadequacies ( a m>riage1 ! unrew>d+ nature ( a job1 ! ext5t ( conflicts ) a *ild1 or difficulties relat+ to fri5ds c cause int5se anxiety4 ,s1 to avoid ?is anxiety1 we frequ5tly def5d aga9/ ^! realizations3 we try to uphold ! belief t our m>riages are j f9e1 t ?+s are ,,ok betwe5 u & our *ildr51 t our jobs are at lea/ tol]able--t1 9 spite ( "s problems "h & !re1 we c get along all "r4 ,we d1 9 %ort1 try to see our lives ?r\gh rose-t9t$ glasses4 ,we cont9ue to d ?is until our negative feel+s become too /rong1 until we h exp5d$ s mu* en]gy to ma9ta9 our def5ses t we are emotionally exhau/$4 ,if we rea* su* a /ate ( real depletion1 & our def5ses c no long] hold aga9/ ! build+ pressure ( our feel+s1 ! result is #cc n]v\s breakd[n4 ,?is is ! layman's "n = a v>iety ( psy*ological conditions t develop due to a burn$-out emotional fuse4 ,a fuse is a protective device t prev5ts an ov]load ( electricity4 ,our def5se me*anisms are analog\s devices t protect u aga9/ emotional ov]load4 ,:5 an emotional fuse burns out1 x is (t5 because we h ma9ta9$ def5ses too long 9 ! face ( increas+ inn] fru/ration & pa94 ,! result may involve sev]e depression1 incapacitat+ anxiety1 or s]i\s )drawal4 ,n[1 :5 y decide to *ange 9 "s psy*ologically fundam5tal way1 y mu/ pu% aga9/ ! rigid framework ( c]ta9 ( ^! protective def5ses4 ,:5 y d ?is1 y w feel anxiety4 ,y are =c+ y\r emotional fuses to adju/ to a diff]5t patt]n ( behavior & feel+s4 ,y\r s5se ( p]sonal id5tity is made up ( a network ( ways y h come to p]ceive y\rself1 y\r lov$ ones1 y\r "w1 & y\r _w4 ,any attempt--ev5 if x is y\r own1 ent]$ into ?r\gh y\r own *oos+--to *ange patt]ns t are psy*ologically basic to y\r s5se ( id5tity w ?reat5 t e/abli%$ id5tity & produce a measure ( anxiety4 ,! long] ^! habitual patt]ns ( behavior & feel+ h be5 9 =ce1 ! m deeply root$ !y become 9 y\r s5se ( id5tity1 & ! m unsettl+ & anxiety-produc+ an attempt to *ange !m w be4 ,al?\gh y\r def5ses protect aga9/ emotional ov]load1 !y also /& 9 y\r way ( *ange4 ,!y are fundam5tally cons]vative me*anisms3 e/abli%$ habits ( ?\ght1 feel+1 & behavior are famili>1 & famili>ity r$uces ! anxiety br\ght ab\t by unc]ta9ty4 ,if y are consid]+ mak+ significant *anges 9 y\r life1 y\r def5ses w rally to protect ! equilibrium ( habits y h =m$ 9 ! pa/4 ,if y pu% y\rself to *ange1 y w face a pr$ictable degree ( anxiety4 ,=tunately1 !re are1 z we %all see1 _m ways ( cop+ ) ! anxiety br\ght ab\t by *ange2 !rapy (f]s "s ( ^!1 & "s are available to u all if we draw on inn] res\rces4 ,z long z y are alive x is possible to *ange4 ,ultimately1 ! decision to *ange is an expression ( y\r *oice & w4 ,:5 *ange is a*iev$1 x usually comes aft] long & ardu\s try+4 ,we are all aw>e ( ! h]oic ef=ts "s #cd p c & d make to ov]come a physical h&icap4 ,ov]com+ deeply entr5*$ emotional habits c require simil> t5acity & commitm5t4 ,if y want to br+ ab\t "s basic *anges 9 y\rself or 9 y\r relation%ips ) o!rs1 y\r inn] /r5g? & resolve w be ess5tial4 ,frequ5tly1 individuals expect a !rapi/ to accompli% *ange = !m3 !y are will+ to come = an h\r's consultation once or twice a week1 & !y w be v coop]ative dur+ ea* visit1 b !y seem unwill+ or unable to develop ! initiative to c>ry on ef=ts begun 9 ! !rapi/'s (fice4 ,"s cli5ts1 9 spite ( :at !y say1 d n really want to *ange4 ,_! habits are deeply +ra9$1 s]v+ purposes !y may be only dimly aw>e ( at ! beg9n+ ( !rapy4 ,sometimes x becomes necess>y 9 !rapy to reappraise ! goals t h be5 set4 ,! decision to pursue a c]ta9 c\rse ( *ange may result 9 s mu* anxiety & upset t bo? !rapi/ & cli5t mu/ pause to reconsid]4 ,"s *anges may turn out to be too difficult1 too tax+2 "s cli5ts may be unwill+ to put 9 ! "w requir$ to br+ ab\t a c]ta9 *ange4 ,mo/ *anges ( ! k9d ,i am ref]r+ to--fundam5tal *anges 9 outlook1 9 daily ?\ghts & feel+s1 9 behavior--c be made only gradually4 ,s9ce any move 9 ! direction ( *ange w ?reat5 y\r exi/+ def5ses1 resi/ance & prote/ are likely to well up f )9 y4 ,new ways ( be+ w feel intimidat+1 unpleasant1 or j pla9 unnatural4 ,& ?is is und]/&able1 is x n8 ,y mu/ confront & d battle aga9/ habits t may h be5 ) y = a long "t4 ,! long] t undesirable patt]ns h be5 9 =ce1 ! m control !y acquire ov] y1 & ! m y\r def5ses become committ$ to pres]v+ !m4 ,*ange is made /eadily m difficult4 ,always rememb]1 h[ev]1 t *ange c be br\ght ab\t4 ,y ne$ to be pati5t ) y\rself2 x w n come ov]night4 ,long-/&+ habits take "t to be replac$1 ,y mu/ h pati5ce1 & y mu/ feel hope & enc\ragem5t4 ,if y are depress$ n[1 if ma9ta9+ y\r def5ses has exhau/$ y1 !n x w be difficult to feel ! measure ( hope t y ne$ to beg9 ! process ( !rapy4 ,?is1 p]haps m ?an any?+ else1 is ! mo/ imm$iate & p]ceptible b5efit ( !rapy3 a good !rapi/ is a s\rce #ce = hope & enc\ragem5t :5 y _c su/a9 ^! y\rself4 ,!rapi/s are tra9$ to help p :o want to *ange1 to br+ x ab\t4 ,,! ,,results ,,( ,,!rapy ,9 ! pa/ tw5ty to ?irty ye>s1 !re has be5 a gradual %ift away f a m$ical1 illness-bas$ ori5tation 9 !rapy to "o t focuses on p]sonal gr[?4 ,by no means ev]yone ent]s !rapy because ( emotional pa94 ,increas+ly1 !rapi/s are see+ cli5ts :o enjoy psy*ological & emotional good heal? b believe t !rapy c help !m lead full]1 ri*]1 m satisfy+ lives4 ,z a consequ5ce1 ! objectives ( _m curr5t approa*es to !rapy involve m ?an only ! resolution ( p]sonal difficulties & crises4 ,!re are _m pot5tial b5efits ( !rapy4 ,to v>y+ degrees1 all ! !rapies we w discuss 9 ?is book claim to assi/ y 9 a*iev+ ! foll[+ goals4 ,resili5ce & ,tol]ance to ,/ress ,z a consequ5ce ( !rapy1 y come to be less fru/rat$ by /ress1 able to recov] f /ressful exp]i5ces m quickly4 ,y become less def5sive & m accept+ ( o!rs & y\rself1 able to adju/ m easily to unexpect$ dem&s 9 liv+4 ,y h a decreas$ t5d5cy to hold rigid expectations ( ! _w1 s y feel less disappo9tm5t & fru/ration4 ,congru5ce ,y come to be m unifi$ 9 ! pres5t mom5t1 aw>e ( y\r feel+s1 & less dispos$ to ignore1 d5y1 or di/ort y\r p]ceptions out ( def5sive ne$s4 ,congru5ce means a close mat* betwe5 :at y feel & h[ y ?9k & act4 ,congru5t p are well integrat$1 no long] 9 ne$ ( masks4 ,:5 we admire a p]son's s5se ( integrity1 we (t5 feel t ! p]son n only behaves 9 ways t %[ self-respect1 b t he or %e is self-accept+1 is g5u9e1 & appe>s to be comp>atively free ( inn] conflict4 ,su* individuals are1 9 %ort1 able to be !mselves4 ,p :o no long] are engag$ 9 a battle aga9/ !mselves & aga9/ o!rs w t5d to %[ congru5ce4 #cf ,self-,e/eem ,p ) high self-e/eem c all[ !mselves to feel mode/ & to behave ) mode/y4 ,high self-e/eem does n imply pride or arrogance4 ,self-e/eem & self-acceptance 7& h5ce congru5ce7 are int]relat$4 ,individuals ) /rong self-e/eem no long] ne$ to prove !mselves4 ,!y value ! k9d ( p !y are & are n incl9$ to be self-und]m9+ ?r\gh p]fectioni/ic self-criticism4 ,op5ness & ,love ,ideally1 if y und]go !rapy1 y become less def5sive & less uptight ab\t y\rself2 y w !re=e h less ne$ = self-absorption1 s y w be able to develop an increas$ capacity to feel w>m? = o!rs4 ,y may become m giv+1 & less hook$ on ! ne$ to recov] = :at y d give1 tit = tat4 ,!re are few] %\lds to /& 9 y\r way1 to use to blame y\rself1 or to use to criticize o!rs4 ,y c let g ( ^! requirem5ts & accept o!rs = :at !y are1 = :at !y c d1 & = :at !y may feel4 ,y feel less disappo9tm5t & res5tm5t ab\t y\r relation%ips & m ( a s5se ( ease & peace4 ,fre$om ,s9ce y are less hook$ by ! expectations & values ( o!rs1 & y h r$uc$ ! li/ ( requirem5ts t o!rs mu/ fulfill 9 ord] to be acceptable1 y ga9 a great measure ( p]sonal fre$om4 ,! habitual process ( siz+ o!rs up & comp>+ !m ) y\rself1 :i* _m ( u exp5d s mu* "t & en]gy do+1 is no long] ne$$4 ,y c m freely set y\r life goals4 ,y w probably feel m real1 mean+ful satisfaction ) y\r life1 s9ce y are no long] imprison$ by uptight /&>ds ( judgm5t4 ,y are able to be mu* m relax$ because y are able to feel m accept+ t[>d o!rs & t[>d y\rself4 ,displac+ ! ,negative ) ! ,positive ,^! are among ! major pot5tial positive b5efits ( !rapy4 ,!y make up "o way ( describ+ ! ideal outcomes ( !rapy4 ,!y are "o side ( ! co92 ! o!r side consi/s ( ! _m negative feel+s & ways ( behav+ t are #cg elim9at$ :5 !y are displac$ by ^! positive p]sonality qualities4 ,! negatives t make up su* a famili> "p ( normal life include ^!3 99 fe>s t /& 9 ! way ( desir$ goals 99 anxiety & depression t cripple normal liv+ 99 l[ self-e/eem1 res5tm5t1 & ho/ility t poison ! =mation & developm5t ( satisfy+ relation%ips 99 incapacity to deal ) /ress1 & dep5d5ce on alcohol1 drugs1 or o!r means to r$uce anxiety 99 inability to accept y\rself1 y\r family1 or y\r pres5t place 9 ! _w--:i* (t5 leads to bitt]ness1 )drawal1 & ev5 ! cultivation ( fantasies t fur!r isolate 99 confusion1 disori5tation1 & p]haps ev5 physical signs ( poor heal?1 z a result ( emotions t h assum$ a magnitude t c no long] be held 9 *eck by tir$ def5ses ,we t5d to ?9k ( ^! z ! usual reasons = ent]+ !rapy4 ,b1 aga91 ! positive qualities we h describ$ are attract+ cli5ts increas+ly to !rapy4 ,:e!r y ne$ to elim9ate emotional pa9 or are =tunate to be comp>atively untr\bl$ b are se>*+ = c]ta9 positive qualities ( p]spective & "* t y believe w br+ increas$ satisfaction to y\r liv+1 !rapy may (f] :at y are seek+4 ,,:at ,,makes ,a ,,good ,,!rapi/8 ,accord+ to sev]al /udies1 c]ta9 qualities 9 !rapi/s are associat$ ) effective !rapy4 ,! k9d ( p]son :o is able to help o!rs br+ ab\t important life *anges has ^! qualities3 99 ! ability to und]/& ! cli5t's feel+s & life _w 99 height5$ s5sitivity to ! cli5t's feel+s & attitudes s t ! !rapi/ frequ5tly is able to uncov] significant aspects ( ! cli5t's outlook & p]sonality ( :i* ! cli5t w\ld probably rema9 unaw>e #ch 99 w>m? ( int]e/ 9 ! cli5t's well-be+1 )\t emotional ov]9volvem5t 99 psy*ological maturity1 *>act]iz$ by self-acceptance1 g5u95ess1 & congru5ce 99 a s5se ( acceptance t[>d ! cli5t3 a nonjudgm5tal1 noncritical1 positive reg>d = ! cli5t1 8 sep>at5ess1 & individuality 99 an attitude1 convey$ by ! !rapi/'s behavior & approa*1 t enc\rages positive *ange1 indep5d5ce1 & freely made *oices & decisions1 & implicitly disc\rages ! =mation ( long-t]m dep5d5ce ( ! cli5t on ! !rapi/ ,^! /udies also id5tifi$ sev]al attitudes t cli5ts1 reg>dless ( ! ori5tation ( _! !rapi/s1 felt 7 especially c\nt]productive 9 "s !rapi/s3 99 lack ( int]e/ 99 remot5ess or di/ance 99 excessive sympa?y ,9 g5]al1 cli5ts ^: evaluations ( !rapy h be5 /udi$ appe> to be 9 agreem5t t ! p]sonal "*1 attitudes1 & feel+s ( !rapi/s are m important ?an a !rapi/'s te*nique1 proc$ures1 & !oretical ori5tation4 ,!rapy is an intr9sically human process1 "o t is especially s5sitive to ! human dim5sions ( !rapi/s4 ,lat] we w look at objective evaluations ( ! effectiv5ess ( v>i\s approa*es to !rapy & weigh !m aga9/ ! emphasis t cli5ts place on ! p]sonal qualities ( !rapi/s4 #ci #d ,,! ,,!rapeutic ,,jungle1 ,,"p ,i ,social ,work]s1 ,psy*ologi/s1 & ,psy*iatri/s ,i h reluctantly come to conc$e ! possibility t ! process1 direction1 & end po9ts ( !rapy may diff] 9 diff]5t !rapeutic ori5tations4 ,c>l ,rog]s1 ,on ,becom+ a ,p]son ,fifty ye>s ago1 p ) p]sonal or m>ital problems _h a *oice betwe5 two ma9 k9ds ( assi/ance3 psy*oanalysis & religion4 ,freud's approa* to psy*iatry _h ga9$ popul>ity among physicians1 psy*oanalytic tra9+ 0 be+ made available to cl9ical psy*ologi/s1 & ! ideas ( ,freudian analysis _h come to dom9ate ! public's conception ( !rapy4 ,&1 sometimes ov]look$ 9 ?is context1 ! *ur*--! _w's fai?ful & olde/ psy*iatri/--cont9u$ to (f] spiritual & p]sonal guidance4 ,^! two basic *oices h exp&$ into an impressive--& confus+--array ( diff]5t !rapies4 ,! m ?an "o hundr$ v>ieties ( c\nsel+1 ev5 :5 !y are gr\p$ toge!r1 _c be r$uc$ to few] ?an p]haps tw5ty families ( !rapies4 ,diff]5t c\nsel+ pr(essions h evolv$ t n[ range f social "w to psy*o!rapy to psy*iatry2 religi\s c\nsel+ is /ill (f]$2 & !re are ! new] !rapies ( #dj relaxation tra9+1 bi(e$back1 bio5]getics1 etc41 z well z a r5aissance ( old] approa*es su* z m$itation1 yoga1 & holi/ic practice4 ,! *oices ( fifty ye>s ago seem mode/1 limit$1 & c]ta9ly less p]plex+4 ,h[ev]1 ! rec5t prolif]ation ( !rapies has br\ght ) x increas$ s5sitivity1 sophi/ication1 & effectiv5ess4 ,9 spite ( ?is gr[? ( !rapeutic options1 mo/ p :o decide to ent] !rapy are unaw>e ( ! *oices op5 to !m & s _c intellig5tly weigh _! alt]natives4 ,?is & ! next *apt] w help y to see cle>ly :at alt]natives exi/4 ,z ! book helps y to cl>ify y\r p]sonal objectives1 y w be able to home 9 on "o or m approa*es to !rapy t may be especially promis+ = y1 y\r temp]am5t1 int]e/s1 & goals4 ,y w be enc\rag$ to foll[ a map t w guide y to sev]al approa*es to !rapy1 to help y f9d ! %orte/ & mo/ effective r\te to :]e y want to g4 ,,social ,,"w ,,c\nselors ,z we h se51 ! f\r ma9 categories ( social "w c\nselors are c\nselors = individuals1 m>riage & family c\nselors1 gr\p c\nselors1 & vocational guidance c\nselors4 ,,ori5tation ,,& ,,tra9+ ,! ma9 purpose ( social "w is to help p cope ) /ress f int]p]sonal or social problems4 ,! focus ( ! social work] may !re=e be on individuals1 families1 or gr\ps or on _! social & "w environm5ts1 _! organizations1 & _! communities4 ,social work]s are tra9$ to deal ) developm5tal problems1 life crises1 & emotional problems t arise 9 a v>iety ( social situations4 ,graduate s*ools ( social "w require v>y+ p]iods ( sup]vis$ int]n%ip2 !y usually (f] specializations )9 ! field--e4g41 drug & alcohol abuse1 developm5tal disabilities1 *ild welf>e1 correctional approa*es1 family s]vices1 c>e ( ! ag$1 & o!rs4 ,x is n[ possible to f9d social work]s ^: tra9+ is q specializ$4 #da ,9 "s /ates1 social work]s may practice ) a ba*elor's degree2 9 _m /ates1 a ma/]'s degree is requir$4 ,9 addition1 c\nselors are usually requir$ to put 9 a sub/antial numb] ( h\rs ( c\nsel+ "u ! sup]vision ( a lic5s$ c\nselor4 ,,fees ,social work]s 9 private practice normally *>ge on an h\rly basis = _! s]vices1 ) sessions la/+ ?irty to fifty m9utes4 ,rates v>y consid]ably1 9 direct relation to o!r heal? c>e co/s4 ,rates are high] 9 l>g] metropolitan areas & also high] 9 ,new ,engl& & ,cali=nia ?an 9 ! ,s\? & ,midwe/4 ,an approximate range ( #ce to #fe p] c\nsel+ session is normal at ! "t ( ?is writ+4 ,co/s = m>riage & family c\nsel+ & = vocational guidance c\nsel+ are simil> to rates = individual c\nsel+4 ,! *>ge = gr\p !rapy is frequ5tly made = a block ( sessions4 ,! gr\p !rapi/ may1 = example1 recomm5d t a gr\p meet = t5 sessions4 ,! result+ p]-session co/ is normally significantly l[] ?an is individual c\nsel+4 7,h[ev]1 ! goals ( individual & gr\p !rapy are 9 g5]al diff]5t1 z we w see2 nei!r c automatically be sub/itut$ = ! o!r47 ,_m social work]s (f] _! s]vices ?r\gh a c\nsel+ ag5cy4 ,"s ( ^! are privately run2 o!rs are fund$ by ! c\nty or /ate4 ,frequ5tly1 ag5cies *>ge = c\nsel+ s]vices bas$ on a slid+ scale1 :i* takes into acc\nt ! f9ancial situation ( cli5ts4 ,slid+ scale rates c be v economical = l[]-income individuals4 ,bills = s]vices 9 "s c\nty & /ate ag5cies are made on a mon?ly basis2 individual c\nsel+ may co/ only a few doll>s p] session = individuals ) re/rict$ budgets4 ,!re are _m opportunities = cli5ts to obta9 economical c>e1 especially 9 metropolitan areas :]e c\nsel+ s]vices are widespread4 ,,duration ,,( ,,treatm5t ,x is impossible to give any h>d & fa/ rules z to h[ long #db c\nsel+ w take4 ,obvi\sly1 mu* has to d ) an individual's objectives1 ! sev]ity ( ! problem1 &1 frequ5tly1 h[ long ! problem has be5 neglect$ or ignor$4 ,on ! o!r h&1 mu* also has to d ) ! c\nselor's own ori5tation4 ,today1 _m c\nselors receive tra9+ t emphasizes brief !rapy4 ,specific goals ( !rapy are set1 & x is frequ5tly possible to rea* ^? goals )9 a matt] ( a few mon?s4 ,on ! o!r h&1 "s c\nselors pref]1 or h be5 tra9$1 to (f] long-t]m individual psy*o!rapy4 ,"s c\nselors h be5 influ5c$ by ! psy*oanalytic approa*1 :i* is usually ( long duration1 frequ5tly requir+ "o to sev]al ye>s4 ,!re is no reason y1 z a prospective cli5t1 %\ld n ask a c\nselor :at k9d ( approa* he or %e uses & approximately h[ long !rapy c be expect$ to la/4 ,y %\ld n hesitate to ask a c\nselor que/ions t reflect y\r conc]ns4 ,z y read fur!r1 ?is book w provide y ) a frame ( ref]5ce s t y may evaluate m fully ! answ]s a c\nselor gives y4 ,,psy*ologi/s ,z m5tion$ 9 ! la/ *apt]1 !re are ?ree k9ds ( psy*ologi/s :o are involv$ 9 diff]5t aspects ( !rapy3 cl9ical psy*ologi/s1 c\nsel+ psy*ologi/s1 & psy*ometri/s4 ,,ori5tation ,,& ,,tra9+ ,cl9ical psy*ology emphasizes ! und]/&+1 diagnosis1 & treatm5t ( individuals 9 psy*ological di/ress4 ,cl9ical psy*ology is hi/orically bas$ on laboratory "w t /ress$ psy*ological assessm5t te/s1 & exp]im5tal & /ati/ical analysis4 ,cl9ical psy*ologi/s g5]ally h a ,ph4,d4 & complete a l5g?y int]n%ip 9 a cl9ical sett+4 ,mo/ cl9ical psy*ologi/s develop compet5ce 9 bo? diagno/ics & int]v5tion4 ,! area ( diagno/ics includes individual int]views1 psy*ological te/+1 & p]sonality assessm5t 7psy*ological evaluation to det]m9e :at a cli5t's difficulties are74 ,int]v5tion 7! actual approa* us$ to help a p]son7 includes individual psy*o!rapy1 gr\p !rapy1 & m>riage & family !rapy4 #dc ,! objective ( c\nsel+ psy*ology is to enc\rage gr[? 9 ! ?ree major life areas ( family1 "w1 & education & to prev5t excessive psy*ological /ress 9 !m4 ,l cl9ical psy*ologi/s1 c\nsel+ psy*ologi/s receive tra9+ 9 individual1 gr\p1 & m>riage & family c\nsel+ z well z 9 vocational c\nsel+1 assessm5t1 & rehabilitation4 ,(t51 y w f9d cl9ical psy*ologi/s 9 private practice1 :ile _m c\nsel+ psy*ologi/s hold positions 9 organizations1 s*ools1 & social s]vice ag5cies4 ,c\nsel+ psy*ologi/s g5]ally h a ma/]'s degree or ,ph4,d4 & also are requir$ to complete int]n%ips 9 sup]vis$ c\nsel+4 ,psy*ometri/s are specifically tra9$ to give & to evaluate psy*ological te/s4 ,!y are1 s to speak1 ! radiologi/s ( ! fields ( c\nsel+ & psy*o!rapy4 ,cli5ts may be ref]r$ to a psy*ometri/ 9 ord] to take "o or m psy*ological te/s2 ! psy*ometri/'s int]pretation ( ! results is !n =w>d$ to ! cli5t's !rapi/ or c\nselor4 ,increas+ly1 psy*ologi/s are be+ tra9$ to d mu* ( ?is "w !mselves1 s x has become less common to ref] cli5ts to psy*ometri/s unless an ext5sive am\nt ( te/+ is desir$4 ,if y are advis$ to take "o or m psy*ological te/s1 y may be int]e/$ 9 kn[+ :at to expect4 ,_m psy*ological te/s are multiple-*oice4 ,y are giv5 a pr9t$ li/ ( que/ions & an answ] %eet4 ,!re are no "r answ]s4 ,y answ] su* que/ions z ,w\ld y r g to a p>ty or /ay home & read a good book8 ,te/s l ?is attempt to provide insight into a cli5t's outlook1 p]sonality1 conc]ns1 values1 & int]e/s4 ,"s te/s help to assess conc5tration1 coord9ation1 & problem-solv+ ability4 ,results ( psy*ological te/s c be helpful to a c\nselor 9 decid+ h[ be/ to treat a cli5t's problems4 ,te/+ c be a great "t- & money-sav] 9 !rapy3 ! results ( a tw5ty-m9ute te/ c give a c\nselor in=mation ab\t a cli5t t might o!rwise be ga9$ only ?r\gh a numb] ( sessions4 ,,fees ,because ( _! m advanc$ tra9+1 cl9ical psy*ologi/s c be expect$ to *>ge fees t are some:at high] ?an :at social work]s 9 private practice receive4 ,*>ges = #dd ! s]vices ( a cl9ical psy*ologi/ are made on an h\rly basis2 c\nsel+ sessions usually la/ =ty-five to fifty m9utes1 al?\gh "s psy*ologi/s w see cli5ts = %ort] p]iods4 ,rates v>y consid]ably accord+ to geographical area4 ,an approximate range ( #ej to #hj p] private session is normal at ?is "t4 ,gr\p session rates t5d to be significantly l[]4 ,if y consult a cl9ical or c\nsel+ psy*ologi/ :o works ?r\gh an ag5cy1 y w (t5 f9d t a slid+ scale is us$ to det]m9e *>ges1 z 9 social "w4 ,if y h limit$ or no heal? insurance1 & f9ancial conc]ns are a problem1 y c telephone c\nsel+ ag5cies 9 y\r area to ask :e!r a slid+ scale is us$ &1 if s1 :at *>ges correspond to y\r mon?ly income4 ,lat]1 we w look at h[ to locate c\nsel+ ag5cies1 z well z pr(essionals 9 private practice4 ,fees = psy*ological te/+1 :e!r ?r\gh a psy*ologi/ or a psy*ometri/1 are usually bill$ on ! basis ( ! te/s adm9i/]$4 ,to give "s idea1 _m te/s co/ #ae to #bj = a psy*ologi/ to adm9i/]4 ,?is *>ge is pass$ on to ! cli5t4 ,! te/ results c sometimes be review$ dur+ a c\nsel+ session s t no additional *>ge may be made = ! evaluation ( ! results4 ,,duration ,,( ,,treatm5t ,duration ( treatm5t "u a cl9ical or c\nsel+ psy*ologi/ is simil> to t ( a social "w c\nselor4 ,! be/ way to proce$ is to ask prospective !rapi/s h[ long !y believe x w be necess>y to see !m4 ,mo/ pr(essionals w be op5 & c&id2 if ! cli5t's goals are specific & l5d !mselves to brief !rapy1 a psy*ologi/ w make ?is cle>4 ,&1 z we h already obs]v$1 mu* dep5ds on ! type ( !rapy practic$ by ! psy*ologi/4 ,behavioral !rapies t5d to be ( %ort] duration2 psy*oanalysis is long]-t]m4 ,9 betwe5 ^! !re are1 z we w see1 _m !rapies t h diff]5t emphases1 me?ods1 & goals4 ,,psy*iatri/s ,,ori5tation ,,& ,,tra9+ ,be=e !y specialize 9 psy*iatry1 psy*iatri/s receive ! #de tra9+ requir$ ( any physician4 ,aft] ?is1 !re is specializ$ c\rse "w foll[$ by a p]iod ( psy*iatric int]n%ip4 ,! educational backgr\nd ( psy*iatri/s enables !m sometimes to id5tify physical bases = emotional difficulties4 ,a lat] *apt] discusses ?is gr[+ area ( aw>5ess4 ,until fairly rec5tly1 ! !rapeutic tra9+ ( psy*iatri/s emphasiz$ almo/ exclusively ! approa* ( psy*oanalysis4 ,psy*oanalysis develop$ )9 a m$ical context3 ,freud 0 a physician1 & 8 outlook 0 influ5c$ by 8 m$ical ori5tation4 ,8 approa* 0 !re=e felt to be ! special prov9ce ( psy*iatric m$ic9e4 ,ev5tually1 z we h already notic$1 ! me?ods ( psy*oanalysis came to be us$ by psy*ologi/s & "s social work]s4 ,b = a long p]iod1 analysis 0 ! prim>y & exclusive focus ( m$ical psy*iatry4 ,! psy*oanalytical ori5tation /ill dom9ates mu* psy*iatry1 & _m psy*iatri/s 9 private practice use psy*oanalysis z _! !rapy ( *oice4 ,h[ev]1 !re has be5 a g5]al broad5+ ( ! p]spective ( psy*iatri/s4 ,o!r approa*es to psy*o!rapy are increas+ly be+ us$ by psy*iatri/s4 ,cognitive !rapy is important among ^!2 we w discuss its purpose & me?ods lat]4 ,psy*iatri/s are ! only !rapi/s :o may prescribe m$ication1 & "s ( ! mo/ important rec5t advances 9 psy*iatry h come 9 ?is area4 ,_m emotional problems appe> to h a bio*emical basis4 ,_m =ms ( anxiety1 panic disord]s1 & depression respond well to ! gr[+ family ( psy*oph>maceutical drugs4 ,o!r emotional difficulties1 includ+ alcohol & drug abuse1 c be mod]at$ by ph>maceutical !rapy4 ,psy*iatri/s1 !n1 c be especially helpful 9 ^! ways3 99 to provide a m$ical evaluation = compla9ts t sometimes h a physical basis 99 to give assi/ance especially by means ( psy*oanalysis & by means ( an increas+ numb] ( alt]native !rapies 99 to help pati5ts ) m$ication to acquire a degree ( emotional equilibrium t w all[ !m to beg9 to solve p]sonal problems s t1 9 "t1 !y may no long] require m$ication #df ,al?\gh an ,m4,d4 may call h]self or himself a psy*iatri/1 mo/ psy*iatri/s h _h specializ$ advanc$ tra9+ 9 psy*iatry4 ,full qualifications involve completion ( a resid5cy 9 psy*iatry1 full memb]%ip 9 ! ,am]ican ,psy*iatric ,association1 completion ( a program ( /udy at an in/itute ( psy*o!rapy1 & bo>d c]tification4 ,_m psy*iatri/s :o practice are eligible = bo>d c]tification b simply h n yet tak5 ! national exam9ations t are requir$ 9 ord] to be c]tifi$ by a national exam9+ bo>d4 ,al?\gh app>5tly _m ( u ne$ to be reassur$ ( ?is1 y ne$ n feel t !re is any?+ wrong or emb>rass+ ab\t ask+ a prospective psy*iatri/1 or 8 or h] secret>y1 to describe ! doctor's backgr\nd & tra9+4 ,,fees ,at ! "t ( ?is writ+1 ! fees ( psy*iatri/s 9 private practice range approximately f #ge up to #ajj & occasionally m p] session4 ,private psy*iatric assi/ance is !re=e l>gely res]v$ = ! fairly well-to-d or = ^? :o h heal? insurance ) sub/antial psy*iatric b5efits4 ,=tunately1 psy*iatric c>e is available ?r\gh _m ag5cies2 ^? t are run by c\nties & /ates normally h slid+ scales 7"s private ag5cies w also take an individual's f9ances into acc\nt :5 sett+ fees74 ,rates = consultation ) a psy*iatri/ at a public ag5cy c be v reasonable 7z little z a few doll>s p] visit1 dep5d+ on ! pati5t's income74 ,?is makes ! s]vices ( psy*iatri/s available to ^? ) mode/ or l[ incomes4 ,,duration ,,( ,,treatm5t ,if a psy*iatri/ f9ds t an emotional problem has a physical basis1 or t x is due to bio*emical depletion or imbalance 9 ! body1 successful treatm5t may be relatively %ort1 sometimes a matt] ( a few mon?s4 ,if y *oose to ent] psy*oanalysis1 !n ! duration ( treatm5t g5]ally w be long]1 (t5 la/+ a ye> & m2 dur+ ?is "t1 psy*oanaly/s may expect y to come = two or ?ree sessions ea* week4 ,%ort]-t]m !rapies1 su* z cognitive !rapy1 are--9 "p because ( ! normal long duration requir$ by psy*oanalysis--increas+ly advocat$ by psy*iatri/s4 ,bi(e$back & relaxation tra9+ 7see ,*apt] #e7 are also among ^! %ort]-t]m approa*es4 ,!y may be effective )9 a p]iod ( sev]al mon?s4 ,9 ?is *apt]1 we h discuss$ ! pr(essions t make up ! ma9/ream ( pr(essional practice 9 c\nsel+ & psy*o!rapy4 ,h[ev]1 beyond ! e/abli%$ & m closely regulat$ pr(essions ( social work]1 psy*ologi/1 & psy*iatri/1 !re are a numb] ( o!r k9ds ( !rapi/s :o (f] s]vices t are suffici5tly diff]5t 9 nature t !y des]ve to be treat$ 9 a sep>ate *apt]4 ,! next *apt] describes _! contributions to !rapy4 #dh #e ,,! ,,!rapeutic ,,jungle1 ,,"p ,,ii ,outside ! ,ma9/ream ,outside ( any pr(ession's frame ( ref]5ce t def9es :at problems x w h&le & h[1 we usually f9d a gr\p ( approa*es t d n completely fit ! e/abli%$ mold4 ,!y (t5 c contribute creative & innovative ideas1 & yet !y (t5 lead to abuses 9 ! "n ( novelty & exp]im5tation4 ,& sometimes an old] approa* t fails to fit ! new] frame ( ref]5ce is left beh9d1 to keep company ) m radical approa*es4 ,j ^! ?+s h happ5$ 9 ! practice ( c\nsel+ & psy*o!rapy1 z we w see4 ,,religi\s ,,c\nselors ,! _w's fir/ pr(essional c\nselors 7 religi\s4 ,guidance f prie/s1 rabbis1 & pa/ors has a long tradition4 ,! tradition is su* an old "o1 9 fact1 t go+ to talk to a religi\s c\nselor has a respectability t ! public has g5]ally n yet ext5d$ to o!r =ms ( c\nsel+4 ,_m p ) problems1 ev5 p ) a religi\s attitude or upbr++1 t5d to ignore ! k9d ( help religi\s c\nselors may be able to give4 ,?is probably /ems f ! #di belief t social work]s1 psy*ologi/s1 psy*iatri/s1 & "s o!r c]tifi$ !rapi/s :om we w discuss 9 a mom5t h receiv$ special tra9+ 9 help+ p ) p]sonal1 emotional problems1 :]eas religi\s advisors h n4 ,h[ev]1 ?is is n univ]sally true4 ,_m pr(essional religi\s repres5tatives n[ d receive tra9+ 9 contempor>y !rapies4 ,increas+ly1 ,ca?olic1 ,prote/ant1 & ,jewi% educational in/itutions are incorporat+ c\rse "w & work%ops 9 mod]n c\nsel+ me?ods into programs ( /udy = prie/s1 pa/ors1 & rabbis4 ,individuals :o h be5 tra9$ 9 ?is way are easily locat$ )9 a religi\s organization2 a telephone call to ! organization %\ld give y leads to foll[4 ,9 spite ( ! widespread attempt _m religi\s in/itutions are mak+ to rema9 up to date on contempor>y approa*es to c\nsel+1 !re is probably some?+ also to be said = traditional guidance4 ,all religi\s views seek to fulfill ! ne$s ( m5 & wom5 to f9d mean+ 9 ev]yday life & to cope effectively ) life's h>d%ips4 ,contempor>y approa*es to psy*o!rapy & c\nsel+ c (f] mu*2 _! hi/ory1 h[ev]1 is comp>atively brief1 ext5d+ ov] j ! la/ c5tury4 ,= _m p--dep5d+ on _! incl9ations1 values1 & sympa?ies--traditional religi\s guidance may provide mu* t is z yet n to be f\nd 9 ! m sci5tific & sy/ematic s*ools ( contempor>y !rapy4 ,if y decide to g to a religi\s pr(essional = c\nsel+1 y w probably f9d ! process relatively in=mal & fri5dly4 ,also1 religi\s pr(essionals g5]ally expect t _! private c\nsel+ s]vices w n be remun]at$2 contributions to ! support+ religi\s organization are ( c\rse hop$ = b are (t5 n requir$ 9 ex*ange = guidance4 ,9 contra/ to ! au?oriz$ community ( social work]s1 psy*ologi/s1 & psy*iatri/s1 x c be m difficult to locate a religi\s pr(essional :o specializes 9 a p>ticul> approa* to c\nsel+4 ,! backgr\nd 9 mod]n approa*es to c\nsel+ t religi\s pr(essionals t5d to receive is eclectic4 ,!y normally receive tra9+ 9 a v>iety ( approa*es2 _! programs ( /udy are bas$ on ! belief t flexibility 9 c\nsel+ is ess5tial1 t no?+ works well = ev]yone4 ,?is op5ness c be ( value to _m p4 ,b1 z y read ?is book1 y may decide to locate a !rapi/ :o has a c]ta9 #ej specific ori5tation4 ,he or %e may be a religi\s c\nselor1 a psy*ologi/1 or ano!r qualifi$ pr(essional4 ,9 g5]al1 if y h a specific =m ( !rapy 9 m9d1 y w h to ask a prospective !rapi/ :e!r he or %e has ! tra9+ to give y ! k9d ( help y are look+ =4 ,?is is especially true ( religi\s c\nselors4 ,,bi(e$back ,,!rapi/s ,bi(e$back is a newcom] to ! !rapeutic _w t has gr[n trem5d\sly 9 popul>ity 9 ! la/ t5 ye>s or s4 ,bi(e$back !rapy gradually enables individuals to become aw>e ( c]ta9 physical *anges 9 _! bodies4 ,^! physical *anges are detect$ by means ( s5sitive measur+ in/rum5ts t give in=mation back to cli5ts s !y c le>n to control a p>ticul> physical response4 ,bi(e$back is us$ by !rapi/s :o h be5 specially tra9$ 9 its use1 z well z by "s lic5s$ psy*ologi/s1 psy*iatri/s1 social work]s1 physical !rapi/s1 spee* pa?ologi/s1 & ev5 "s d5ti/s4 ,"s psy*iatri/s n[ "w jo9tly ) a bi(e$back !rapi/3 ! psy*iatri/ c prescribe m$ication & provide psy*o!rapy or analysis1 :ile ! associat$ bi(e$back !rapi/ c tea* pati5ts h[ to less5 _! responses to pa9 & /ress-relat$ problems4 ,! ,bi(e$back ,society ( ,am]ica is an int]discipl9>y gr\p ( heal?c>e pr(essionals2 x is pres5tly develop+ tra9+ /&>ds & guidel9es = c]tification ( bi(e$back practition]s4 ,,relaxation1 ,,hypnosis1 ,,& ,,m$itation ,,!rapi/s ,relaxation tra9+1 hypnosis1 & m$itation all seek to br+ ab\t a deep s5se ( relaxation 9 a p]son4 ,we w exam9e ea* 9 great] detail lat]2 a %ort ov]view ( ^! approa*es is giv5 "h4 ,,relaxation ,,tra9+ ,relaxation tra9+ involves ex]cises t enable a p]son to le>n to induce at w a /ate ( physical & m5tal calm4 ,relaxation tra9+ is a practical skill--x c be v effective #ea & useful 9 cop+ ) /ressful situations4 ,l any le>n$ skill1 control comes only ) practice1 usually ov] a p]iod ( sev]al mon?s4 ,_m social work]s & psy*ologi/s tea* cli5ts relaxation te*niques4 ,c]tification /&>ds specifically = relaxation tra9+ h n be5 e/abli%$4 ,,hypnosis ,hypnosis involves two /ages3 7#a7 progressive1 deep relaxation to a po9t at :i* an individual is 9 a peaceful1 trancelike /ate1 /ill self-aw>e b pr(\ndly relax$2 & 7#b7 sugge/ion1 :i* p]suades ! p]son to adopt c]ta9 future attitudes1 ?\ghts1 or behavior4 ,hypnosis1 l relaxation tra9+1 c be le>n$4 ,mo/ p treat$ by means ( hypnosis /eadily improve 9 _! ability to be hypnotiz$ s t !y c m effectively all[ !mselves to be influ5c$ by means ( c>efully plann$ sugge/ions4 ,_m psy*ologi/s & psy*iatri/s make use ( hypnosis 9 ! context ( !rapy2 "s practition]s treat pati5ts exclusively by means ( hypnosis4 ,! c]tification ( !rapi/s tra9$ 9 hypnosis is /ill unsettl$ 9 _m /ates1 :]e anyone c hang out a %+le4 ,s9ce _m lic5s$ psy*ologi/s & psy*iatri/s & "s c]tifi$ social work]s d receive pr(essional tra9+ 9 hypnosis1 ^! are ! pr(essions to :i* x is mo/ reliable to g = hypno!rapy4 ,,m$itation ,m$itation is /ill a fr+e !rapy4 ,te*niques ( m$itation t5d seldom to be taught to cli5ts 9 psy*o!rapy1 al?\gh !re is a gr[+ body ( evid5ce t m$itation is able to br+ ab\t great resi/ance to /ress1 an increas$ s5se ( inn] calm1 & ev5 actual *anges 9 bra9-wave patt]ns associat$ ) deep relaxation4 ,^! effects ( m$itation are n[ be+ /udi$1 ) enc\rag+ results4 ,! practice ( m$itation is1 9 ! au?or's view1 at pres5t be/ le>n$ on "o's own1 al?\gh "s comm]cial organizations provide in/ruction4 ,a lat] *apt] discusses approa*es to m$itation & sugge/s "s ( ! ways m$itation c be ( value4 #eb ,,holi/ic ,,!rapies3 ,,bio5]getics1 ,,yoga1 ,,& ,,ex]cise ,holism views man z a unity ( body & m9d4 ,! e/abli%$ approa*es to !rapy & c\nsel+1 repres5t$ by social work]s1 psy*ologi/s1 psy*iatri/s1 & to a c]ta9 ext5t by "s religi\s pr(essionals1 all focus att5tion on our m5tal-psy*ological dim5sion4 ,simil>ly1 bi(e$back1 hypnosis1 & m$itation emphasize ! c5tral role ( m5tal control4 ,holi/ic approa*es1 on ! o!r h&1 attempt to br+ ab\t positive *ange by means ( emphasis on physical factors t are believ$ to h a close connection to m5tal processes4 ,al?\gh holism sees human be+s z integral organisms1 holi/ic approa*es are incl9$ to h ?is physical focus4 ,holi/ic !rapies1 l m$itation1 are fr+e !rapies4 ,!y are n g5]ally employ$ by memb]s ( ! au?oriz$ community ( heal? practition]s1 = two reasons3 ,fir/1 a k9d ( pr(essional respectability & elitism h come to be associat$ ) ! psy*ological approa*2 social "w1 psy*ology1 & psy*iatry h an e/abli%$ place 9 in/itutions ( high] le>n+1 :]eas fr+e !rapies d n4 ,second1 s9ce physicians treat ! body1 !re is an in/itutionaliz$ prejudice aga9/ nonm$ical treatm5t t has ! same focus4 ,*iropractic has enc\nt]$ ?is problem1 z h o!r =ms ( holism1 su* z bio5]getics1 yoga1 diet !rapy1 & rolf+4 ,al?\gh mu* ( value may be (f]$ by ^! fr+e !rapies1 !y h also result$ 9 abuse to consum]s4 ,because ( a g5]al abs5ce ( lic5s+ /&>ds & ( sci5tific cr$ibility1 p frequ5tly are drawn 9 by ! sometimes extravagant promises ( unscrupul\s or ov]ly en?usia/ic fr+e !rapi/s4 ,9 ?is area1 z 9 all o!rs t affect ! consum]1 ! prop] attitude is "o ( heal?y skepticism & re/ra9t4 ,,bio5]getics ,( ^! holi/ic !rapies1 bio5]getics is p]haps consid]$ ! mo/ respectable because x is us$ by "s psy*ologi/s4 ,bio5]getics attempts to dim9i% an individual's psy*ological def5ses by means ( sequ5ces ( specially design$ #ec physical ex]cises t1 9 a controll$ & delib]ate way1 /ress ! p]son physically4 ,practition]s ( bio5]getics believe t physical ex]cises ( ?is k9d rapidly put a p]son 9 t\* ) buri$ 7repress$7 feel+s & spe$ up ! process ( inn] integration t all holi/ic practices1 z well z traditional !rapy1 wi% to a*ieve4 ,,yoga ,yoga exi/s 9 v>i\s =ms4 ,! two ma9 v>ieties are ha?a yoga & raja yoga4 ,ha?a yoga emphasizes physical flexibility2 raja yoga tea*es brea?+ te*niques & m$itation4 ,ha?a yoga1 because ( its focus on ! body1 belongs to ! family ( approa*es we are consid]+ "h4 ,ha?a yoga practition]s believe t ! physical flexibility & control t are acquir$ ?r\gh an ext5d$ p]iod ( physical tra9+ 9 yoga ex]cise t5d to influ5ce y\r m5tal ori5tation4 ,y become1 9 ?is view1 m flexible1 less rigid1 less def5sive1 less subject to /ress1 m op51 responsive1 al]t1 & capable ( w>m? 9 human relation%ips4 ,,ex]cise ,,!rapy ,c\nselors & !rapi/s are />t+ to take v s]i\sly ! idea t ex]cise br+s emotional b5efits4 ,ex]cise !rapy1 m s ?an o!r physically bas$ approa*es discuss$ 9 ?is *apt]1 has be5 te/$ 9 v>i\s ways4 ,_m emotional conditions--= example1 anxiety & depression--seem to be significantly r$uc$ ?anks to p]iods ( su/a9$ vigor\s ex]cise4 ,tol]ance to /ress & to pa9 appe>s to be increas$4 ,physical ex]cise c be an outlet = p5t-up ho/ility & aggression t1 accord+ to _m !ori/s1 may be turn$ inw>d1 !n fe/]1 & ev5tually take ! =m ( a v>iety ( psy*ological disord]s4 ,fur!rmore1 vigor\s1 su/a9$ a]obic ex]cise--l runn+ or swimm+--appe>s to h a calm+ effect z a result ( c]ta9 *emical comp\nds t are releas$ into ! blood/ream4 ,we w look at "s ( ! int]e/+ rec5t /udies ( ! !rapeutic value ( ex]cise lat] on4 #ed #f ,,:]e ,,y ,,c ,,f9d ,,help ,,private ,,practice ,z we h se51 social "w c\nselors1 psy*ologi/s1 psy*iatri/s1 bi(e$back !rapi/s1 hypno!rapi/s1 & o!r !rapi/s may all (f] _! s]vices ?r\gh private practice4 ,9 g5]al1 !re c be def9ite advantages to c\nsel+ 9 ! sett+ ( a !rapi/'s private practice4 ,y are giv5 a degree ( p]sonal c>e t1 z an individual pay+ cu/om]1 y are less likely to receive 9 c\nsel+ provid$ by ag5cies4 ,y become "p ( a !rapi/'s own practice1 s x is natural = him or h] to devote special att5tion to y4 ,!rapi/s are likely to be m p]sonally involv$ 9 _! private practice & 9 ! quality ( c>e !y try to give _! private cli5ts ?an x is possible or ev5 p]sonally desirable = !m to be :5 !y "w by ! h\r = an ag5cy4 ,on ! o!r h&1 private sessions ) a !rapi/ t5d to be consid]ably m exp5sive ?an c\nsel+ c be ?r\gh _m ag5cies4 ,y ought n to take too s]i\sly g5]al comp>isons betwe5 !rapy z y may enc\nt] x privately & !rapy 9 ! sett+ ( an ag5cy4 ,y c (t5 f9d a c\nselor :o is cong5ial1 int]e/$1 att5tive1 & skill$2 ^: s]vices w be easi] = y to be> f9ancially2 & :o #ee (f]s 8 or h] s]vices ?r\gh an ag5cy4 ,if f9ances are re/rictive = y1 y %\ld look into ag5cy-sponsor$ c\nsel+4 ,_m social "w c\nselors1 psy*ologi/s1 & "s psy*iatri/s :o ma9ta9 private practices int5d$ ma9ly = individual !rapy also (f] gr\p !rapy4 ,(t51 a !rapi/ w obs]ve t a numb] ( individual cli5ts %>e c]ta9 problems & exp]i5ces1 & he or %e w sugge/ t ^! p meet toge!r z a gr\p4 ,! p]-session price c be expect$ to be a good deal l[] ?an = individual sessions2 ! rate usually reflects ! numb] ( p :o meet 9 ! gr\p & ! l5g? ( "t ! gr\p is expect$ to cont9ue4 ,"s social work]s & "s psy*ologi/s specialize 9 gr\p !rapy4 ,gr\ps are =m$ p]iodically1 run a set numb] ( weeks1 & may or may n br+ toge!r individuals ) common problems4 ,"s gr\p !rapi/s believe t div]sity 9 a c\nsel+ gr\p is valuable3 9 su* a gr\p1 y might f9d "o p]son combat+ alcoholism1 ano!r try+ to cope ) lonel9ess & grief aft] ! dea? ( a sp\se1 someone try+ to break out ( ! conf9es ( %yness1 a p]son suff]+ f public speak+ anxiety1 someone want+ to *ange c>e]s b :o is block$ by fe>1 & o!rs4 ,an ex*ange ( views among p>ticipants ) div]se backgr\nds c frequ5tly enc\rage gr[? 9 ! gr\p memb]s4 ,mo/ c\nsel+ ag5cies also (f] gr\p !rapy1 z d _m hospitals & s*ools4 ,we w take a look at ea* ( ^! sett+s 9 turn4 ,,c\nty1 ,,/ate1 ,,& ,,private ,,ag5cies ,individual1 m>riage & family1 & gr\p c\nsel+ are all (f]$ by _m c\nsel+ ag5cies4 ,c\nty & /ate ag5cies receive public fund+ & usually h slid+ scales = ! rates !y *>ge4 ,(t51 "o or m psy*iatri/s "w 9 association ) c\nselors1 :o may be social work]s or psy*ologi/s4 ,if y g to a c\nty or /ate ag5cy1 y w probably be int]view$ initially by a receptioni/ or nurse4 ,y w be ask$ que/ions ab\t y\r f9ancial situation & heal? insurance cov]age1 if y h any1 & y w be ask$ to agree to a propos$ rate = ! s]vices ( ! ag5cy4 ,"s c\nty & /ate ag5cies make a mon?ly *>ge #ef = _! s]vices2 y may consult regul>ly ) memb]s ( ! /aff1 c\nselors &_/or psy*iatri/s1 9 accordance ) y\r individual ne$s4 ,private c\nsel+ ag5cies function 9 a simil> way4 ,_! s]vices t5d to be m exp5sive because !y d n receive public f9ancial support1 z d c\nty & /ate ag5cies4 ,_m heal? insurance plans t provide psy*ological b5efits c be us$ to pay = ! s]vices ( a private or a public c\nsel+ ag5cy4 ,,hospitals ,,& ,,o!r ,,inpati5t ,,s]vices ,individuals ) sev]e problems :o ne$ complete c>e c ent] private1 c\nty1 or /ate hospitals t (f] psy*iatric s]vices4 ,a sep>ate *apt] discusses pros & cons ( ! sometimes fright5+ alt]native ( hospitalization4 ,aga91 publicly fund$ hospitals t5d to *>ge on ! basis ( a slid+ scale1 :i* takes a p]son's f9ancial situation into acc\nt4 ,:]e f9ancial conc]ns are n press+1 private hospitals 9 g5]al t5d to (f] a great] degree ( individual att5tion & high] quality ( c>e & physical facilities4 ,9 addition to hospital facilities1 _m metropolitan areas h e/abli%$ organizations to provide c\nsel+ s]vices on an inpati5t basis4 ,"s are private2 "s are public4 ,!y (f] an alt]native to hospitalization4 ,!y t5d to be m in=mal & op5 & are manag$ by _! own /affs ( pr(essional c\nselors & psy*iatri/s4 ,^! resid5tial c>e facilities usually are int5d$ = /ays ( f "o to sev]al weeks4 ,!y h a v>iety ( c\nsel+ programs1 rang+ f individual !rapy to gr\p c\nsel+ & vocational guidance4 ,"o way to locate su* an inpati5t organization is to telephone a crisis int]v5tion 7sometimes call$ suicide prev5tion7 numb] likely to be li/$ at ! beg9n+ ( y\r telephone directory4 ,a volunte] probably w answ] y\r call & %\ld be able to direct y to inpati5t facilities available 9 y\r area4 ,,academic ,,s\rces ,,( ,,c\nsel+ ,c\nsel+ is "o ( ! s]vices available to full- & "p-"t #eg /ud5ts :o are enroll$ 9 junior or f\r-ye> colleges & graduate s*ools4 ,_m educational in/itutions (f] individual c\nsel+1 normally by c\nsel+ psy*ologi/s1 & all colleges (f] academic advis+ 9 ! context ( a c]ta9 am\nt ( vocational guidance4 ,colleges ) programs 9 c\nsel+ & psy*ology usually also (f] c]ta9 classes ) a practical1 problem-solv+ focus4 ,al?\gh !y may n be specifically int5d$ to help individual /ud5ts ) life problems1 ?is is 9 fact :at !y frequ5tly end up do+4 ,x is inevitable = /ud5ts 9 a practically ori5t$ c\nsel+ class to apply mu* t !y le>n to _! own problems4 ,_m class meet+s ( ?is k9d t5d to be almo/ indi/+ui%able f gr\p !rapy sessions3 /ud5ts receive guidance f a pr(essionally tra9$ in/ructor1 ex*ange views1 & express p]sonal conc]ns4 ,y might ?9k ( college classes ) a practical1 psy*ological emphasis especially if y are drawn to !rapy z an opportunity = g5]al p]sonal gr[?4 ,classes ( ?is k9d may be (f]$ 9 a college's regul> programs1 :i* are sometimes op5 only to /ud5ts work+ t[>d a degree4 ,o!r simil> opportunities1 h[ev]1 are available ?r\gh _m cont9u+ education1 or adult education1 programs4 ,_m second>y s*ool di/ricts (f] practical1 psy*ologically-focus$ classes = adults :o d n *oose to ent] a degree program4 ,?is is also true ( community1 /ate1 & _m private colleges4 ,colleges & private pr(essionals (f] int5sive work%ops ) a v>iety ( c\nsel+ emphases4 ,two-day week5d work%ops h become especially popul>4 ,topics range f alcoholism1 drug abuse1 *ild-re>+ problems1 & sep>ation & divorce to illness & *ronic pa91 m>ital conc]ns1 depression1 /ress control1 & s on4 ,newspap]s ann\nce c\nsel+ work%ops2 y w (t5 f9d notices ab\t !m po/$ 9 public & college libr>ies4 ,,"s ,,reflections ,,on ,,:]e ,,y ,,g ,,= ,,c\nsel+ ,y %\ld be> 9 m9d t :]e y g = c\nsel+ or !rapy is no?+ m ?an an address4 ,:at is important is :at happ5s 9 y\r relation%ip ) y\r c\nselor or #eh !rapi/4 ,if y h f\nd a !rapi/ :om y respect & feel motivat$ to "w )1 x makes little diff]5ce1 z f> z ! b5efits y obta9 f !rapy are conc]n$1 :e!r y\r !rapi/ works 9 private practice or (f]s 8 or h] s]vices ?r\gh an ag5cy1 s*ool1 hospital1 or resid5tial facility4 ,on ! o!r h&1 :]e y g = c\nsel+ w greatly det]m9e ! price y w pay = s]vices & frequ5tly :e!r heal? insurance w cov] y\r exp5ses4 ,to "s ext5t1 :]e y g c sometimes1 z we h not$1 influ5ce ! quality ( c>e & individual att5tion y receive4 ,b ?is is a g5]alization2 y frequ5tly w be able to locate excell5t c>e ?r\gh less exp5sive facilities4 ,?is w dep5d to "s ext5t on luck1 b m on ! am\nt ( ef=t y put into locat+ ! k9d ( help y may ne$4 ,s9ce y are read+ ?is book1 y already h initiative l ?is3 y h ! ability to influ5ce :at k9d & quality ( !rapy y w receive4 ,= y1 x w be less a matt] ( pure luck ?an x is = p :o *oose a !rapy & !rapi/ arbitr>ily4 #ei #g ,,self-,,diagnosis ,mapp+ ,y\r ,way to a ,!rapy ,?is *apt] is c5tral to y\r use ( ?is book z a guide4 ,!re are two ma9 ways to use ?is book to help y to *oose a !rapy3 #a4 ,y c famili>ize y\rself ) all ( ! major approa*es to !rapy1 weigh _! advantages & disadvantages 9 relation to y\r ne$s1 & !n make a *oice4 ,tw5ty-six approa*es to !rapy are discuss$ & evaluat$ 9 ?is book1 s keep+ y\r judgm5ts ( _! pros & cons cle>ly 9 m9d c be *all5g+4 ,al?\gh compreh5sive und]/&+ has a value ( its own1 x may n be ess5tial to y4 #b4 ,y may pref] to g ?r\gh ?ree simple /eps to n>r[ ! alt]natives d[n to a small numb] ( !rapies t h be5 mo/ successful = specific goals1 problems1 & p]sonal attributes t mo/ closely approximate y\r own4 ,?is is a less "t-consum+ process1 & x w take into acc\nt pr(essional evaluations ( ! diff]5t !rapies4 ,9 ei!r case1 y\r in=m$ judgm5t w be ! basis = y\r ev5tual *oice4 ,?is *apt] is int5d$ to help y if y pref] ! second r\te--to n>r[ d[n ! alt]natives 9 a cle> & logical way4 ,if y pref]1 h[ev]1 to become acqua9t$ ) all ( ! major !rapies discuss$ 9 ?is book1 #fj y might skim ?r\gh sections ( ?is *apt] to give y a framework = m effici5t und]/&+4 ,! in=mation 9 ?is *apt] relates to _m diff]5t sets ( goals1 problems1 & k9ds ( p4 ,n all ( ?is in=mation w be relevant to y1 s y w f9d in/ructions to direct y to specific recomm5dations t take into acc\nt y\r own ne$s & int]e/s4 ,?is *apt] is :]e practical & prud5t plann+ c beg94 ,9 fact1 ?is book repres5ts ! fir/ attempt to mat* y1 y\r p]sonal qualities1 & y\r goals ) ! mo/ effective !rapy or !rapies available to y4 ,ev5 ?\gh ne>ly all ( ! ma9 approa*es to c\nsel+ & !rapy are creations ( ! pa/ c5tury1 x may seem surpris+ t no unifi$ ef=t has be5 made to id5tify :at specific k9ds ( problems ea* approa* is especially useful = treat+ & = :at types ( cli5ts4 ,9 ?is respect1 ! field ( m$ic9e is mu* bett] develop$4 ,! discipl9e ( m$ical diagno/ics is n[ on ! v]ge ( becom+ sci5tific1 & x is n[ possible to id5tify = _m conditions & 9 individual cases v concrete & well-def9$ treatm5t proc$ures t are likely to be effective4 ,?is has n be5 true 9 ! field ( psy*ology3 mo/ rese>* ef=ts h s f> gone into =mulat+ def9itions ( ! v>i\s m5tal & emotional disord]s4 ,b ! important "w1 f ! prospective cli5t's po9t ( view1 _h yet to be done3 to make x possible = him to "k--9 relation to 8 individual problems1 goals1 int]e/s1 abilities1 & temp]am5t--:i* approa*es to !rapy are likely to help him ! mo/4 ,if y are 9 s]i\s emotional pa91 wait+ until all ( ! rese>* results are 9 is j n possible2 y ne$ help n[4 ,9 spite ( incomplete k 9 psy*o!rapy1 a l>ge body ( in=mation has come f /udies ( ! effectiv5ess ( !rapies = diff]5t problems & = diff]5t k9ds ( p4 ,b until n[ ?is in=mation exi/$ only 9 fragm5t$ =m & 0 famili> only to pr(essional psy*ologi/s4 ,en\gh data are 9 to beg9 to draw reasonable guidel9es = individuals :o seek psy*ological help4 ,! mapp+ process describ$ 9 ?is *apt] is ! result ( assembl+ & !n organiz+ l>ge quantities ( data f _m s\rces4 ,x 0 !n necess>y to design an easily foll[$ #fa /ep-by-/ep approa* to enable y to n>r[ d[n ! _m !rapeutic alt]natives to a small numb] t1 ?r\gh y\r ef=ts & ! assi/ance ( a !rapi/1 c be ( help to y4 ,guidel9es ( ?is k9d are nev] /atic2 !y w *ange to "s ext5t z "t & k advance4 ,,ob/acles ,,to ,,f9d+ ,a ,,!rapy ,,t ,,fits ,,y ,!re are real ob/acles to effici5t treatm5t 9 psy*o!rapy4 ,!y co/ p mu* "t1 en]gy1 hope1 & money z !y try to f9d appropriate help4 ,psy*o!rapy is n yet a sy/ematic field4 ,!re are ?ree ma9 reasons :y x is s difficult to f9d approa*es to !rapy t w fit individual cli5ts & _! ne$s3 99 ,emotional & m5tal difficulties v>y trem5d\sly4 ,psy*ologi/s & psy*iatri/s are /ill 9 ! process ( classify+ ! k9ds ( emotional & m5tal problems p h4 99 ,p are individuals4 ,_! p]sonalities1 likes & dislikes1 & motivations = ent]+ !rapy diff] greatly4 99 ,!rapi/s1 too1 are individuals4 ,_! p]sonalities1 int]e/s1 values1 & motivations = (f]+ !rapy diff] greatly4 ,_! pr(essional tra9+ & pref]5ces 9 favor ( "o or sev]al approa*es to !rapy also v>y significantly4 ,z a result1 :at works = "o pati5t w n necess>ily "w = ano!r4 ,:at helps & :o helps 9 "o p]son's situation may n help 9 ano!r's4 ,yet all ?ree ( ! factors on :i* effective treatm5t dep5ds--a pati5t's goals & problems1 8 or h] p]sonality traits1 & ! approa* ( ! !rapi/--9 _m cases c be mat*$ intellig5tly4 ,y1 z a prospective cli5t1 "k a great deal ab\t y\rself2 x doesn't make s5se to *oose arbitr>ily among ! _m !rapies4 ,x takes v little "t to map y\r way3 9 ! process1 y w le>n m ab\t y\rself1 :at to anticipate 9 !rapy1 & 9 :at direction to />t4 #fb ,,realism3 ,a ,,good ,,beg9n+ ,9 ord] to id5tify "o or m !rapies t may be mo/ promis+ 9 relation to y\r goals1 y\r problems1 & ! k9d ( p]son y und]/& y\rself to be1 y mu/ beg9 y\r se>* ) a good measure ( realism4 ,,sett+ ,,goals ,x c be v difficult = anyone :o is s]i\sly tr\bl$ to ?9k cle>ly & use good judgm5t4 ,y may f9d x h>d1 p]haps impossible1 at ?is "t to id5tify y\r goals4 ,y may feel confus$1 anxi\s1 depress$1 & n "k :y y feel t way4 ,ev5 s1 y w f9d z y read on t y c set important goals = y\rself4 ,if y are at a loss & h no s5se ( purpose1 t fact gives y a goal to "w t[>d 9 !rapy3 to develop cle>ly ?\ght-out goals4 ,?\gh y may n "k :at precipitat$ y\r feel+s ( confusion1 anxiety1 or depression1 y at lea/ "k t y feel confus$1 anxi\s1 or depress$1 & y w f9d recomm5dations 9 ?is *apt] on h[ to f9d appropriate help = y\r suff]+4 ,d n judge y\rself h>%ly if y lack a s5se ( direction or if y are tr\bl$ b d n "k :y4 ,j keep read+4 ,,op5+ ,,y\rself ,,to ,,*ange ,!re is a second ?+ y %\ld be reali/ic ab\t :5 y d "k :at y want & :at y\r problems are4 ,our exp]i5ces & :at we le>n ab\t ourselves *ange u4 ,if y ent] !rapy bas$ on y\r pres5t p]ceptions ( y\rself1 x is likely t ^! are go+ to *ange to "s ext5t z a result ( y\r exp]i5ces 9 !rapy4 ,does t mean t y _c plan or select a !rapy intellig5tly8 ,cle>ly1 x doesn't4 ,ev]yone has to />t :]e he or %e is4 ,!re is no o!r *oice4 ,b y %\ld try to p]suade y\rself to be op5 to *anges 9 y\r views & feel+s4 ,if y feel rigid ab\t y\r own p]ceptions ( y\rself1 x is j possible t y\r rigidity may be contribut+ to ! problems y want to resolve4 ,z 9 any attempt to le>n or to *ange1 x is important p]iodically to reevaluate y\r ne$s1 values1 & ! results y may h a*iev$ s f>4 ,if y select a !rapy us+ ! /ructur$ #fc approa* 9 ?is *apt]1 y may decide to retrace y\r foot/eps a few mon?s 9 ! future4 ,y may f9d t y w\ld take a diff]5t pa? 9 ! light ( :at y !n see4 ,,be+ ,,hone/ ,,ab\t ,,y\rself ,!re is a ?ird piece ( realism t ,i w\ld l y to consid]1 & ?is is v h>d = anyone to take to he>t4 ,if y c1 y are a v unusual p]son4 ,answ]+ ! foll[+ que/ions hone/ly takes "s real c\rage4 ,b y mu/ ask y\rself3 ,to :at ext5t d ,i ne$ my pres5t symptoms8 ,is x useful to me n to h a s5se ( direction8 ,am ,i someh[ b5efit+ f feel+ depress$8 ,is my anxiety helpful to me 9 "s way8 ,y may ?9k ^! sugge/ions are no m ?an contriv$ & unk9d psy*ologiz+4 ,aft] all1 :o *ooses to suff]8 ,does anyone want to wake up at #d3jj ,a4,m4 %ak+ & cry+8 ,yet1 aga9 & aga91 !rapi/s :o c>e v mu* ab\t _! pati5ts f9d t _m ( !m cl+ to _! symptoms ) ! desp]ation ( a dr[n+ man hang+ onto a raft4#a #a ,lewis ,r4 ,wolb]g1 ,hypnosis 7,new ,york3 ,h>c\rt ,brace ,jovanovi*1 #aigb71 p4 #bch4 7,9 ?is guide1 see ,*apt] #ae1 on hypnosis47 ,= div]se reasons1 _m p--ev5 p :o are suff]+ greatly--d n want to *ange4 ,_! unhapp9ess1 pa91 & confusion c s]ve num]\s functions4 ,y may n believe ?is "r n[1 b f "t to "t z y read ?is book1 & lat] 9 y\r life1 ?is "q may occur to y1 if only = a mom5t3 ,h[ may ?is unresolv$ problem b5efit me8 ,! pla9 tru? is t ev5 suff]+ c conf] b5efits on u4 ,?is is at ! root ( mu* ( ! trag$y ( emotional problems t prove to be resi/ant to treatm5t4 ,! di/ress$1 despond5t1 ov]wr\ght1 & trembl+ p]son seat$ be=e ! !rapi/ may h f\nd a way to ga9 ! att5tion he 0 unable to get o!rwise4 ,or p]haps 8 suff]+ is a way to light5 a burd5 ( guilt t ev5tually caus$ an inn] collapse4 ,!re are _m b5efits1 _m v good reasons to want n to *ange b to try anyway4 ,s1 be=e y beg9 to seek a specific type ( !rapy1 try to be reali/ic & keep ^! ?\ghts 9 m9d3 #fd #a4 ,specify+ cle>-cut goals & und]/&+ :y y feel tr\bl$ are n ess5tial n[4 ,c]ta9ly x w be helpful if y c translate vague compla9ts into concrete problems1 to help bo? y\r own und]/&+ & ev5tually y\r !rapi/'s4 ,! m specific y c be ab\t :at is tr\bl+ y1 :at situations especially di/ress y1 & :at has motivat$ y to come to !rapy1 ! easi] x w be = y to f9d help & = ! !rapi/ y *oose to help y4 ,b 9 times ( crisis1 cl>ity c be v h>d to ga91 s be pati5t4 #b4 ,if y d h cle>-cut goals & a good und]/&+ ( y\rself n[1 use ^! to plan h[ to proce$1 rememb]+ t op5ness to *ange w pr(it y & t1 9 all likelihood1 y\r initial p]ceptions ( y\rself w *ange z y become involv$ 9 !rapy4 #c4 ,y may1 at lea/ n[1 ne$ y\r symptoms1 h[ev] pa9ful !y may be4 ,h[ successful !rapy w be = y may h a great deal to d ) y\r will+ness to let g ( ! possible b5efits ( be+ tr\bl$1 9 pa91 or disabl$4 #d4 ,resi/ digg+ ruts = y\rself4 ,try to refra9 f lock+ into a p>ticul> c\rse ( action until y h giv5 y\rself "t to consid] alt]natives4 ,once y h *os5 a direction1 if aft] a reasonable "t ! !rapy & ! !rapi/ y h select$ d n seem to be help+ y1 x is ess5tial to try ano!r approa*4 ,?is is especially difficult once y h inve/$ y\r "t1 en]gy1 & money & p]haps h develop$ a good relation%ip ) y\r !rapi/4 ,y may l him or h]1 feel com=table & com=t$1 b if y are n ga9+ :at y want1 y h to /op & try aga94 #e4 ,f9ally1 h a ?or\gh physical exam9ation be=e ent]+ !rapy1 if y h n _h "o rec5tly4 ,be tru?ful & op5 ) y\r physician4 ,"s emotional & m5tal problems are produc$ by und]ly+ physical conditions1 _m ( :i* c be treat$ effectively 7see ,*apt] #h74 ,,h[ ,,to ,,map ,,y\r ,,way ,,to ,a ,,!rapy ,! rema9d] ( ?is *apt] pres5ts a ?ree-/ep process #fe = *oos+ an approa* to !rapy t is pot5tially be/-suit$ to y\r p]sonal ne$s & p]sonality4 ,9 ! fir/ /ep1 y become famili> ) ! ma9 k9ds ( goals & problems t motivate p to ent] !rapy4 ,y *eck ^? t seem to be mo/ relevant to y & !n try to confirm ! accuracy ( y\r *oices4 ,?is w po9t y 9 ! direction ( "o or m promis+ !rapies4 ,9 ! second /ep1 y consid] a li/ ( ! ma9 p]sonality traits t are relevant to y\r *oice ( !rapy4 ,aga91 y *eck ^? t seem mo/ to apply to y & !n confirm y\r self-und]/&+4 ,/ep #b w also direct y to "o or m !rapies4 ,9 ! ?ird /ep1 y use y\r results f ,/ep #a & ,/ep #b to select an approa* to !rapy t mo/ closely mat*es y\r ne$s1 int]e/s1 & p]sonality4 ,let's beg94 ,,/ep #a4 ,,diagnos+ ,,y\r ,,problems ,,& ,,sett+ ,,y\r ,,goals3 ,,id5tify+ ,,appropriate ,,!rapies a4 ,read ?r\gh ,table #a 7pages #fg-fi74 b4 ,*eck ! goals or problems mo/ applicable to y4 ,if y are 9 d\bt1 ref] to ! numb]$ %ort descriptions 9 ! section ,mat*+ ,y\r ,goals & ,problems ) ,mo/ ,promis+ ,!rapies foll[+ ,table #a4 c4 ,*oose "o or two goals or problems t are ! mo/ important to y4 d4 ,confirm y\r *oices3 ,ref] to ! section ,mat*+ ,y\r ,goals & ,problems ) ,mo/ ,promis+ ,!rapies t foll[s ,table #a4 ,9 t section1 read ! correspond+ %ort descriptions ( ! "o or two goals or problems y *eck$ 9 ,table #a & ask y\rself :e!r1 9 fact1 ^! accurately apply to y4 ,= example1 if y *eck$ #g 9 ,table #a1 !n read ! correspond+ #g 9 ,mat*+ ,y\r ,goals & ,problems ) ,mo/ ,promis+ ,!rapies4 e4 ,if1 aft] do+ ?is1 y cont9ue to believe t ! goals or problems y *eck$ relate to y1 make a record ( ! !rapy lett] codes giv5 at ! end ( ea* description4 ,y w f9d t occasionally lett] codes are divid$ into two gr\ps3 ^? judg$ to be g5]ally m effective 7call$ prim>y71 & a set ( alt]natives 7second>y74 ,n[ g directly to ,/ep #b4 ,on ! o!r h&1 if y come to feel t ! goals or problems y *eck$ really d n apply to y1 g back to ,table #a & consid] o!r alt]natives4 #ff ,,/ep #b4 ,,self-,,und]/&+3 ,,id5tify+ ,,appropriate ,,!rapies a4 ,read ?r\gh ,table #b 7page #gi74 b4 ,*eck ! p]sonal qualities t seem be/ to describe y4 c4 ,*oose "o or two ( ^! t are ! mo/ significant to y4 d4 ,confirm y\r self-und]/&+3 ,ref] to ! section ,mat*+ ,y\r ,p]sonality ) ! ,mo/ ,promis+ ,!rapies foll[+ ,table #b4 ,read ! %ort descriptions ( ! "o or two p]sonal qualities y *eck$ & respond to ! que/ions y w f9d !re4 e4 ,if1 aft] do+ ?is1 y believe t ! p]sonal qualities y *eck$ 9 ,table #b d1 9 fact1 describe y accurately1 make a record ( ! !rapy lett] codes giv5 at ! end ( ! que/ions4 ,n[ g directly to ,/ep #c4 ,if1 on ! o!r h&1 judg+ f y\r responses to ! que/ions y answ]$1 y d n feel t ! p]sonal qualities y *eck$ are true ( y1 return to ,table #b & consid] o!r alt]natives4 ,,/ep #c4 ,,*oos+ ,a ,,!rapy a4 ,comp>e ! two sets ( lett] codes y record$ z a result ( ,/eps #a & #b4 ,if "o or m lett] codes are common to bo? sets1 make a special note ( ! common code7s72 o!rwise1 gr\p ! lett] codes toge!r4 b4 ,ref] to ,table #c 7pages #hf-hg71 :i* summ>izes ! lett] codes ( all ! !rapies discuss$ 9 ?is guide4 ,*eck ! code7s7 y j li/$4 c4 ,if y feel t y h tak5 y\r "t1 h be5 ?\ghtful ab\t y\rself1 & n[ feel reasonably confid5t ab\t ! t5tative conclusions y h rea*$1 turn to ! *apt]7s7 9 ?is book t discuss ! approa*es to !rapy y *eck$4 ,z y read ^!1 try to imag9e y\rself z a cli5t 9 ea* ( ! !rapy situations describ$4 ,:i* approa* seems mo/ appropriate giv5 y\r goals or problems8 ,d y feel t y h ! p]sonal traits t ! !rapy is mo/ suit$ =8 ,if s1 give t approa* to !rapy a reasonable trial p]iod4 ,if n1 consid] o!r alt]natives y *eck$4 #fg ,,an ,,example ,,( ,,foll[+ ,,/eps #a1 #b1 ,,& #c ,suppose y *eck #c4a1 %yness passivity1 9 ,table #a4 ,y ref] to ! section foll[+ ,table #a1 relat+ to p]sonality trait problems4 ,y feel t %yness is some?+ t int]f]es significantly ) y\r life1 int]e/s1 & desires1 & y want to d some?+ to ov]come x4 ,!rapies ,q1 ,c1 ,n1 & ,d are recomm5d$ to y z pot5tially useful4 ,!n1 9 ,table #b1 y *eck #g4 ,y ref] to #g foll[+ ,table #b1 & y decide t y especially ne$ to "w on p5t-up feel+s 9 ne$ ( release4 ,!rapies ,c & ,j are sugge/$ !re z pot5tially appropriate = y4 ,y n[ h two sets ( !rapy lett] codes to consid]3 ,q1 ,c1 ,n1 & ,d2 & ,c & ,j4 ,!rapy ,c is common to bo? recomm5d$ gr\ps ( !rapies1 b y are int]e/$ 9 comp>+ ! o!r !rapies ) ,c4 ,9 addition to read+ ab\t ,c1 y decide to read ! discussions ( !rapies ,d1 ,j1 ,n1 & ,q4 ,f ,table #c1 ! five lett] codes ,c1 ,d1 ,j1 ,n1 & ,q d5ote ,ge/alt !rapy1 transactional analysis1 bio5]getics1 c\nt]-condition+1 & gr\p !rapy1 respectively4 ,aft] read+ ab\t ^! !rapies1 y come to feel t ,ge/alt !rapy probably w\ld *all5ge y 9 especially ne$$ ways1 s y decide to locate a !rapi/ ) tra9+ 9 ,ge/alt !rapy4 7,= in=mation on locat+ a !rapi/1 see ,*apt] #ag47 ,,/ep #a ,,table #a3 ,,an ,,ov]view ,,( ,,pr9cipal ,,goals ,,& ,,ma9 ,,emotional ,,& ,,m5tal ,,disord]s ,,t ,,lead ,,p ,,to ,,ent] ,,!rapy #a ,p]sonal developm5t goals #a4a develop+ new skills & p]sonal traits3 education lead+ to gr[? #a4b elim9at+ self-de/ructive habits or undesirable p]sonality traits3 re-education lead+ to *ange 7see #c bel[7 #fh #b ,disord]s usually fir/ notic$ 9 *ildhood or adolesc5ce #b4a m5tal ret>dation #b4b autism #b4c emotional di/urbances3 sep>ation anxiety1 sleep t]ror & sleepwalk+ disord]s1 etc4 #b4d suff]+ f *ildhood pa91 neglect1 or abuse2 traumatic exp]i5ces f *ildhood1 unmet *ildhood ne$s #b4e behavior problems3 hyp]activity1 antisocial behavior1 movem5t disord]s 7see #aj bel[7 #b4f del9qu5cy & crim9al behavior #b4g eat+ disord]s3 obesity1 bulimia1 anorexia n]vosa #c ,p]sonality trait problems #c4a %yness_/passivity #c4b lonel9ess_/empt9ess #c4c ho/ility_/ov]be>+ p]sonality #c4d fe> ( )drawal ( affection & ( ab&onm5t #c4e g5]al int]p]sonal problems #c4f ne$ to improve effectiv5ess ( communication skills #c4g difficulties 9 cop+ ) p]sons 9 au?ority #c4h loss ( fai? 9 oneself or 9 o!rs1 or 9 life's purpose or end #c4i l[ self-wor?1 desire = a success-id5tity 7self-e/eem result+ f a s5se ( a*ievem5t7 #c4aj deep disc\ragem5t ) life 7see #e bel[7 #d ,neuroses #d4a anxiety disord]s1 panic disord]s1 po/-traumatic /ress disord]s1 etc4 #d4b phobias #d4c compulsions #d4d nog5ic neuroses 7result+ f s]i\s conflicts betwe5 oppos+ values7 #d4e psy*osomatic disord]s1 hypo*ondria #d4f sexual disord]s #d4g impulse control disord]s3 e4g41 pa?ological gambl+1 kleptomania1 pyromania #fi #e ,mood di/urbances 7affective disord]s7 #e4a depression #e4b mania #e4c manic depression #f ,adju/m5t problems #f4a 9 relation to a new environm5t or an already famili> "o2 "w inhibitions #f4b 9 p]sons ) c\nt]culture attitudes & values #f4c emotional difficulties aris+ f pov]ty & f ! deprivations suff]$ by m9ority gr\ps #f4d inability to accept realities t limit life3 e4g41 f9ancial limitations1 re/rict$ opportunities1 ag+ & dea? 7see #i bel[71 jobs ) no future1 responsibilities t /& 9 ! way ( p]sonal developm5t #g ,m>ital problems #h ,family problems #i ,problems relat$ to ag+ #i4a emotional problems 9 fac+ old age #i4b problems fac+ ! rec5tly wid[$ #i4c cop+ ) physical pa9 & disability #aj ,involunt>y behaviors #aj4a /utt]+ #aj4b %ak+ or motor tic disord]s #aj4c insomnia #aa ,crisis int]v5tion3 a ne$ = prompt relief f sev]e symptoms #ab ,psy*oses3 s*izophr5ia1 manic & p>anoid psy*oses1 hy/]ical psy*oses1 etc4 #ac ,organic disord]s #ac4a s5esc5ce1 ,alzheim]'s disease #ac4b ,p>k9sonism_/,hunt+ton's *orea #ac4c sub/ance-induc$3 alcoholism1 drug addiction1 smok+ #ac4d organic bra9 dysfunctions3 epilepsy1 n>colepsy1 amnesia1 dem5tia1 delirium #gj ,,mat*+ ,,y\r ,,goals ,,& ,,problems ,,) ,,mo/ ,,promis+ ,,!rapies #a ,p]sonal ,developm5t ,goals ,^! may involve ei!r 7#a4a7 add+ new skills or qualities or 7#a4b7 subtract+ habits or undesirable traits4 #a4a4 ,!re are basically two diff]5t approa*es to a*iev+ ! fir/ goal3 99 ,y id5tify a specific skill or p]sonality trait y w\ld l to develop--see ,table #a1 #c4 ,= example1 y may want to develop a /rong] success-id5tity 7#c4i71 improve y\r communication skills 7#c4f71 ga9 a /rong] s5se ( life's purpose 7#c4h71 or become m ass]tive 7i4e41 ov]come a degree ( %yness1 #c4a74 ,= ref]5ces to recomm5d$ !rapies = ^! goals1 see #c bel[4 ,= vocational c\nsel+ & !rapy3 ,h1 ,i1 ,m 99 ,alt]natively1 y decide to approa* self-developm5t ) a desire = broad-spectrum improvem5ts4 ,!rapies ) ?is ori5tation are n especially conc]n$ ) highly specific behaviors or problems b attempt to treat ! :ole p]son s t self-e/eem is gradually increas$1 z are a s5se ( satisfaction 9 daily liv+1 enjoym5t ( o!rs1 & a feel+ ( be+ at ease ) !m4 ,prim>y !rapy 7judg$ to be g5]ally m effective73 ,a1 ,b ,second>y !rapy 7some:at less effective73 ,j #a4b4 ,ref] to #c bel[4 #b ,disord]s ,usually ,fir/ ,notic$ 9 ,*ildhood or ,adolesc5ce #b4a4 ,m5tal ret>dation3 ,o #b4b4 ,autism3 self-injur+ behavior1 )drawal f reality3 ,o1 ,y #b4c4 ,emotional di/urbances 9 *ildr53 ,s1 ,w #b4d4 ,suff]+ f *ildhood pa91 neglect1 or abuse3 traumatic exp]i5ces f *ildhood1 unmet *ildhood ne$s 7see #c4d73 ,a1 ,k #ga #b4e4 ,behavior problems 9 *ildr53 ,o1 ,c ,hyp]k9etic behavior3 ,prim>y3 ,y1 ,o ,second>y3 ,z #b4f4 ,del9qu5cy & crim9al behavior3 ,o1 ,e1 ,h1 ,i #b4g4 ,eat+ disord]s3 obesity1 bulimia1 anorexia n]vosa3 ,o1 ,w #c ,p]sonality ,trait ,problems #c4a4 ,%yness_/passivity3 ,q1 ,c1 ,n1 ,d #c4b4 ,lonel9ess_/empt9ess3 ,f1 ,q1 ,d ,s5se ( e/rangem5t1 ali5ation f o!rs3 ,g #c4c4 ,ho/ility_/ov]be>+ p]sonality3 ,e1 ,d1 ,n1 ,q #c4d4 ,fe> ( )drawal ( affection & ( ab&onm5t 7also see #c4b above73 ,r or ,s1 ,d1 ,a #c4e4 ,g5]al int]p]sonal problems3 ,if y are will+ to "w on ^! )9 a wid] focus3 ,a ,involv$ 9 relat+ to o!rs on an individual basis3 ,e1 ,p1 ,w #c4f4 ,ne$ to improve effectiv5ess ( communication skills3 ,d ,9 gr\ps ( p3 ,q #c4g4 ,difficulties 9 cop+ ) p]sons 9 au?ority3 ,c1 ,d #c4h4 ,loss ( fai? 9 y\rself or 9 o!rs or 9 life's purpose or end3 ,f1 ,g1 ,x #c4i4 ,l[ self-wor?3 ,b ,desire = a success-id5tity3 ,h1 ,m #c4aj4 ,deep disc\ragem5t ) life 7see #e bel[73 ,i #d ,neuroses ,a p]son is said to suff] f a neurosis if he or %e has exagg]at$ emotional responses or ideas ( reality t bl[ ?+s out ( proportion4 ,individuals ) neuroses are able to communicate normally or ) mild emotional int]f]5ce4 ,_! emotional problems int]f]e ) normal liv+ b d n impair !m s t _! lives are cle>ly out ( control 7z 9 psy*oses1 alcoholism1 drug addiction1 etc474 #d4a4 ,anxiety disord]s1 panic disord]s1 po/-traumatic /ress disord]s1 etc43 #gb ,anxiety & panic attacks are *>act]iz$ by feel+s ( fe>1 dread1 & t5sion4 ,y may h a s5se ( imm95t disa/] or dea?1 a feel+ ( helplessness (t5 foll[$ by depression4 7,^! are also symptoms ( *ronic anxiety47 ,o!r symptoms ( anxiety & panic attacks include dizz9ess1 dry m\?1 sweat+1 heada*es1 he>t palpitations1 increas$ blood pressure1 rapid brea?+1 weakness1 insomnia1 increas$ ur9ation1 a feel+ ( unreality1 dim9i%$ conc5tration1 memory difficulties1 indecision1 obsessive ?9k+ ab\t anxiety symptoms1 second-ord] anxiety 7anxiety t y are or w be anxi\s71 & desp]ation to obta9 relief4 ,prim>y3 ,y1 ,h1 ,f1 ,v1 ,t1 ,w1 ,x ,second>y3 ,h1 ,k1 ,u ,po/-traumatic /ress disord]s are frequ5tly misdiagnos$ z anxiety disord]s4 ,pati5ts suff]+ f po/-traumatic /ress h be5 expos$ to situations ( great /ress--e4g41 battlefront conditions1 rape1 imprisonm5t 9 a conc5tration camp4 ,^! situations are p]ceiv$ z inescapable1 & !y leave long-la/+ emotional sc>s4 ,symptoms include reactions delay$ until days or mon?s h pass$ s9ce ! trauma situation1 emotional numb+1 *ronic anxiety1 re/lessness1 irritability1 recurr5t nightm>es1 increas$ />tle responses1 impulsive behavior1 & depression4 ,prim>y3 ,y1 9 conjunction ) !rapies recomm5d$ = anxiety & panic attacks4 #d4b4 ,phobias3 ,phobias are fe>s t are disproportionate to ! ?reat ( a situation4 ,!y are involunt>y & _c be reason$ away4 ,!y lead to avoidance ( ! fe>$ situation4 ,prim>y3 ,n1 ,l1 ,y1 ,w1 ,v ,second>y3 ,u1 ,a1 ,k1 ,d ,= fe>s ( public speak+1 especially3 ,e #d4c4 ,compulsions3 ,p ) neurotic compulsions engage 9 repetitive rituals t give !m tempor>y relief f anxiety4 ,compulsive behaviors are (t5 motivat$ by a desire = exactness & p]fection--= example1 compulsive hygi5e1 wa%+1 c\nt+1 pray+1 reflect+ ab\t y\rself1 repetitive isolat$ ?\ghts1 preoccupation ) trifl+ details1 etc4 ,prim>y3 ,e1 ,m1 ,o1 ,a ,second>y3 ,y1 ,t1 ,k ,compulsions t arise1 or may be resolv$1 9 relation to y\r family3 ,s #gc #d4d4 ,nog5ic neuroses3 ,a p]son c be emotionally disabl$ by s]i\s conflicts betwe5 oppos+ p]sonal1 e?ical1 or religi\s values4 ,?is problem has n ga9$ widespread recognition among psy*iatri/s & !rapi/s4 ,x is a focus ( logo!rapy 7see ,*apt] #aa73 ,g #d4e4 ,psy*osomatic disord]s1 hypo*ondria3 ,physical disord]s caus$ by emotional problems are psy*osomatic4 ,examples include "s cases ( colitis1 /oma* cramps1 di>rhea1 con/ipation1 ulc]s1 c>diac arrhy?mias1 impot5ce1 back & neck spasms1 & migra9es4 ,hypo*ondria involves an exagg]at$ conc]n ov] pot5tial & imag9$ symptoms ( disease4 ,physical exam9ation foll[$ by3 ,p1 ,c1 ,n1 ,w1 ,x #d4f4 ,sexual disord]s3 ,^! include impot5ce1 frigidity1 vag9ismus 7vag9al muscle spasm71 premature ejaculation1 & sexual role di/urbances :5 accompani$ by emotional disord]s or poor social function+ 7"s cases ( homosexuality1 transsexualism73 ,p1 ,e1 ,o1 ,n1 ,w2 sometimes ) ,y ,if y are will+ to "w on ?is )9 a wid] focus3 ,a #d4g4 ,impulse control disord]s3 e4g41 pa?ological gambl+1 kleptomania1 pyromania3 ,o1 ,m1 ,e1 ,q #e ,mood ,di/urbances 7,affective ,disord]s7 ,!re are ?ree prim>y mood disord]s3 depression1 mania1 & manic depression4 ,!y may be neurotic1 or !y may be psy*otic1 9 :i* y exp]i5ce halluc9ations1 delusions1 & )drawal f reality4 ,ea* disord] may be situational or nonsituational1 dep5d+ on ! role ( precipitat+ ev5ts1 su* z ! dea? ( a lov$ "o1 loss ( a job1 diagnosis ( t]m9al illness1 etc4 ,situational mood disord]s usually disappe> ) "t4 ,all ?ree disord]s may appe> z isolat$ episodes1 or !y may be recurr5t4 #e4a4 ,depression3 ,cl9ical depression is n simple sadness or grief4 ,sev]ely depress$ p speak sl[ly1 labori\sly4 ,x is difficult = y to ma9ta9 att5tion & conc5tration4 ,y may h feel+s ( hopelessness1 despair1 heav9ess1 self-blame1 height5$ self-criticism1 great pessimism ab\t ! future1 inability to make decisions1 t5d5cies to ?9k ( suicide & sometimes to commit x4 ,dep5d5ce on lov$ ones increases z y feel helpless4 ,int]e/s dim9i% 9 "w1 hobbies1 & fri5ds4 ,y may cry frequ5tly2 y may be irritable & #gd incl9$ to h angry outbur/s4 ,y probably sleep poorly & awak5 frequ5tly1 p>ticul>ly 9 e>ly morn+4 ,anxiety is common 9 ab\t #ej p]c5t ( pati5ts4 ,!re is frequ5tly little appetite = food or = sex3 ,y1 ,e1 ,p1 ,u1 ,t1 ,w1 ,x ,z a s5se ( deep disc\ragem5t ) life3 ,h ,depress$ z a result ( a conflict 9 p]sonal values3 ,g ,if y are will+ to "w on y\r problems )9 a wid] focus 7also see #a4a73 ,a #e4b4 ,mania3 ,y t5d to h exagg]at$ beliefs 9 y\r capabilities2 y t5d to be euphoric & may fall 9 love easily & repeat$ly4 ,y suff] f impulsiv5ess1 poor judgm5t1 rac+ ?\ghts1 sometimes explosive ang]4 ,mild] degrees ( mania are (t5 welcom$ by y1 family1 & fri5ds1 :o admire y\r enorm\s en]gy & y\r _m irons 9 ! fire4 ,only :5 family & fri5ds become aw>e ( y\r poor judgm5t 9 buy+ sprees1 delusions ( gr&eur1 or sexual excesses d !y try to enc\rage y to seek treatm5t1 usually aga9/ y\r own wi%es3 ,y 7especially li?ium !rapy71 ,e1 ,p1 ,t1 ,w1 ,x #e4c4 ,manic depression3 ,y are trapp$ on an emotional roll] coa/]3 at times y are depress$ 7see #e4a71 & at o!r times y exp]i5ce ! highs ( mania 7see #e4b73 ,y 7especially li?ium !rapy71 & !rapies li/$ "u #e4a4 #f ,adju/m5t ,problems ,"s critics ( psy*o!rapy h argu$ t its ma9 purpose is to s]ve ! int]e/s & values ( society3 a p]son is judg$ to be abnormal if he does n want1 or refuses1 = example1 to "w f n9e to five all b two weeks ( ! ye>2 if he does n accept ! responsibilities society claims he %\ld respond to z an adult1 a citiz51 a husb&1 or a fa!r4 ,^! social dem&s--s critics ( !rapy h argu$--h be5 int]naliz$ by mo/ !rapi/s s t !rapies (t5 d n really s]ve ! individual's ne$s b r ! prevail+ belief-sy/em ( society4 ,:atev] validity ! critics' argum5t may h1 x relates p>ticul>ly to ?is area ( emotional suff]+ t falls "u ! head+ ( adju/m5t disord]s4 ,"s adju/m5t disord]s cle>ly lie outside ! b\nd>ies ( ?is criticism4 ,= example1 a woman faces ! loss ( h] husb& & result+ pov]ty4 ,%e becomes anxi\s & depress$1 #ge & ^! feel+s d n g away ) "t4 ,or1 a man agrees to a job transf]1 wants to succe$ at 8 new position1 b is ov]:elm$ by anxiety 9 8 new environm5t4 ,8 anxiety doesn't g away4 #f4a4 ,9 relation to a new environm5t or an already famili> "o2 "w inhibitions3 ,h1 ,m1 ,e1 ,p1 ,n #f4b4 ,9 p]sons ) c\nt]culture attitudes & values3 ,h1 ,d #f4c4 ,emotional difficulties aris+ f pov]ty & f ! deprivations suff]$ by m9ority gr\ps3 ,c #f4d4 ,inability to accept realities t limit life3 e4g41 f9ancial limitations1 re/rict$ opportunities1 ag+ & dea? 7see #i bel[71 jobs ) no future1 responsibilities t /& 9 ! way ( p]sonal developm5t3 ,f1 ,h #g ,m>ital ,problems ,x may be wor? m5tion+ t aft] a p]iod ( !rapy "s problems turn out to be m>ital 9 nature ev5 ?\gh bo? husb& & wife believ$ !m to be an individual's emotional problem--! man's problem1 n ! wife's1 or vice-v]sa1 & c]ta9ly n a m>ital problem4 ,sometimes x is only aft] _m individual sessions ( !rapy t ! m>ital basis ( a problem becomes cle>4 ,:5 appropriate1 ! express$ will+ness ( a sp\se to become involv$ 9 8 or h] p>tn]'s individual !rapy c be a real help1 provid+ emotional & treatm5t support & also sav+ "t :5 9 fact ! m>ital relation%ip itself contributes to ! individual's problems4 ,g5]al m>riage !rapy3 ,prim>y3 ,r1 ,d1 ,e1 ,h1 ,i ,second>y3 ,p1 ,n1 ,i ,= communication problems3 ,r1 ,d #h ,family ,problems ,!re is a gr[+ realization among !rapi/s t _m individual problems are produc$ by families torn by conflict4 ,(t51 family !rapy c provide m effective help to a tr\bl$ individual ?an !rapy t treats ! individual alone4 ,?is seems to be especially true 9 _m cases ( s*izophr5ia 7see #ab bel[7 & 9 fe>s ( )drawal ( affection & ( ab&onm5t 7see #c4d above74 ,g5]al family !rapy3 ,s1 ,d1 ,c1 ,i1 ,n #gf #i ,problems ,relat$ to ,ag+ #i4a4 ,emotional problems 9 fac+ old age3 ,e1 ,g #i4b4 ,problems fac+ ! rec5tly wid[$3 ,h1 ,g #i4c4 ,cop+ ) physical pa9 & disability3 ,u1 ,v1 ,w1 ,y1 ,x #aj ,involunt>y ,behaviors 7see #ac bel[7 #aj4a4 ,/utt]+3 ,u1 ,g1 ,i1 ,o1 ,w #aj4b4 ,%ak+ or motor tic disord]s3 ,u1 ,g1 ,i1 ,y1 ,w #aj4c4 ,insomnia3 ,v1 ,u1 ,w1 ,y #aa4 ,crisis ,int]v5tion3 ,a ,ne$ = ,prompt ,relief f ,sev]e ,symptoms ,crisis telephone hotl9es are available 9 mo/ metropolitan areas = imm$iate c\nsel+ & ref]rals4 ,if su* s]vices d n exi/ 9 y\r area1 y\r family physician1 m9i/]1 local cl9ic1 hospital1 & ev5 police c be ( assi/ance4 ,prim>y3 usually ,y foll[$ by ,b1 ,c1 ,f1 or ,g ,second>y3 ,w1 ,n1 ,o1 or ,p #ab ,psy*oses ,if y h a psy*osis1 y behave 9 response to delusions or halluc9ations4 ,y\r behavior is se5 by o!rs z /range & inappropriate2 y are incl9$ to )draw f social gr\ps4 ,y are sev]ely impair$1 out ( t\* ) reality1 (t5 unable to communicate1 illogical1 rambl+1 incoh]5t4 ,y\r emotional responses are greatly out ( proportion1 ev5 inconsi/5t1 ) ext]nal ev5ts4 ,!re are num]\s =ms ( psy*osis1 includ+ types ( s*izophr5ia1 manic & p>anoid psy*oses1 hy/]ical psy*oses1 & o!rs4 ,s9ce self-diagnosis = ^! conditions is nei!r appropriate nor likely to be accurate1 no detail$ discussion ( ! di/9ct =ms ( psy*osis w be giv5 "h4 ,any diagnosis ( psy*osis requires a c>eful evaluation by a psy*iatri/1 cl9ical psy*ologi/1 or psy*o!rapi/4 ,prim>y3 ,y 7antipsy*otic drugs7 9 conjunction ) ,m1 ,o1 or ,h ,second>y3 ,y ) ,s or ,a2 ,y ) ,t #gg #ac ,organic ,disord]s #ac4a4 ,s5esc5ce1 ,alzheim]'s disease3 ,s5esc5ce is associat$ ) ag+4 ,?ree-qu>t]s ( p]sons sixty-five ye>s old & old] h a *ronic1 disabl+ condition su* z emphysema1 he>t disease1 or hyp]t5sion4 ,mo/ eld]ly individuals are able to cope ) ^! disabilities = ! re/ ( _! lives4 ,"s1 h[ev]1 beg9 to h psy*ological problems associat$ ) s5esc5ce--e4g41 confusion1 depression1 p>anoia1 & sometimes deliri\s /ates3 supportive !rapies3 7e4g41 ,b7 & sometimes ,y ,9 ,alzheim]'s disease1 :i* is a di/9ct disease & n simply a sign ( ag+1 y may h num]\s physical compla9ts t _c be trac$ to a physical illness4 ,y may be irritable1 lack en]gy1 be appreh5sive1 %[ increas+ =getfulness & *anges ( p]sonality4 ,family memb]s may compla9 t y are n y\rself4 ,pres5ile & s5ile dem5tia are two =ms ( ,alzheim]'s disease2 bo? are progressively deg5]ative3 ,y1 c>e by family or by nurs+ home to provide supportive environm5t1 plann+ ( daily activities1 etc4 #ac4b4 ,p>k9sonism_/,hunt+ton's *orea3 ,bo? are movem5t disord]s t c produce psy*iatric problems1 includ+ depression & s*izophr5ic di/urbances4 #ac4c4 ,sub/ance-induc$3 alcoholism1 drug addiction1 smok+4 ,alcoholism3 ,y1 ,o1 ,alcoholics ,anonym\s ,drug abuse3 ,prim>y3 ,y1 ,synanon1 ,o ,second>y3 ,m1 ,d1 ,k ,smok+3 ,o1 ,w ,pot5tially useful = all ( ! above z adjunctive treatm5ts3 ,t1 ,x #ac4d4 ,organic bra9 dysfunctions3 epilepsy1 n>colepsy1 amnesia1 dem5tia1 delirium4 ,!re are num]\s conditions caus$ by abnormalities 9 bra9 function4 ,!y d n l5d !mselves to self-diagnosis or treatm5t4 ,! ma9 treatm5t is3 ,y #gh ,,/ep #b ,,tak+ ,,y\r ,,p]sonality ,,into ,,acc\nt ,:at is *all5g+ = a !rapi/ is disc]n+ ! =m ( le>n+ t ea* pati5t c be/ utilize & !n work+ to adopt te*niques t are be/ suit$ = ! pati5t4444 ,an important area ( rese>* is a way ( detect+ 9 a pati5t 8 optimal modes ( le>n+4 ,if we c p9po9t ^!1 we c !n m precisely det]m9e ! be/ means ( !rapeutic op]ation4#b #b ,lewis ,r4 ,wolb]g1 ,! ,te*nique ( ,psy*o!rapy1 #b vols4 7,new ,york3 ,grune ,/ratton1 #aigg71 vol4 ,i1 p4 #bga4 ,"s p are m am5able to c]ta9 approa*es to !rapy ?an o!rs2 = example1 "s p l & b5efit f gr\p !rapy1 :ile o!rs hate x4 ,sometimes :at a p]son likes or w\ld pref] ne$s to be ov]look$ 9 favor ( treatm5t t is believ$ to be effective4 ,b ! va/ majority ( p :o ent] !rapy d ?is ( _! own volition4 ,if ! !rapy !y ent] is unsatisfy+ or d[nright di/a/eful to !m1 !y w soon give x up4 ,we simply t5d n to le>n & pr(it f exp]i5ces we dislike or t don't fit ! k9ds ( p we are4 ,= "s "t n[ !rapi/s h recogniz$ t a cli5t's p]sonality (t5 t5ds to incl9e him or h] t[>d c]ta9 approa*es & away f o!rs4 ,9 ! second /ep 9 id5tify+ a pot5tially promis+ approa* to !rapy1 y are enc\rag$ to take traits ( y\r own p]sonality into consid]ation4 ,x is n m]ely ! goal or problem t sugge/s a p>ticul> approa* to !rapy1 b--:at is (t5 m important--! nature ( ! p]son4 ,too little att5tion is giv5 to ! appropriat5ess ( an individual = a giv5 k9d ( !rapy4 #gi ,,table #b3 ,,an ,,ov]view ,,( ,,ma9 ,,p]sonality ,,traits ,,relevant ,,to ,,! ,,*oice ,,( ,a ,,!rapy ,*oose no m ?an ?ree ( ! foll[+ t y believe influ5ce mo/ /rongly ! way y approa* day-to-day liv+3 #a ,self-discipl9e #b ,commitm5t to tasks y set = y\rself #c ,pati5ce #d ,initiative #e ,tol]ance to fru/ration #f ,rigidity #g ,inhibition #h ,introv]sion or extrov]sion #i ,motivation & capacity = physical ex]cise #aj ,ne$ = acceptance1 human w>m?1 & g5tle enc\ragem5t #aa ,articulat5ess & analytical attitude #ab ,reflectiv5ess--?9k+ ab\t y\r own feel+s1 ?\ghts1 & behavior #ac ,imag9ation #ad ,s5sitivity to values #ae ,com=t 9 a gr\p sett+ #af ,sev]e impairm5ts--le>n+1 communication1 or emotional disabilities1 includ+ addictions t s]i\sly disrupt y\r daily life #hj ,9 ! foll[+ section1 y w f9d que/ions relat+ to ! sixte5 p]sonal qualities li/$ 9 ,table #b4 ,= ^? qualities y *eck1 answ] ! que/ions z reali/ically z y c4 ,if1 = ! mo/ "p1 y answ] yes to a giv5 gr\p ( que/ions1 !n ! approa*7es7 to !rapy id5tifi$ !re may be especially appropriate = ! k9d ( p]son y are4 ,if y answ] no to mo/ ( ! que/ions 9 a gr\p1 !n ! li/$ !rapy or !rapies may n be especially well suit$ to y4 ,,mat*+ ,,y\r ,,p]sonality ,,) ,,! ,,mo/ ,,promis+ ,,!rapies #a ,self-,discipl9e ,!rapies rely on self-discipl9e 9 cli5ts 9 sev]al ways3 ,are y able to /ick to a prescrib$ r\t9e & d practical assignm5ts on y\r own outside ( !rapy sessions to practice attitudes1 communication skills1 or behaviors8 ,w y take p]sonal responsibility = com+ to regul> appo9tm5ts on "t8 ,c y give up any real pay(fs ( be+ emotionally tr\bl$8 ,:5 any approa* to !rapy is successful1 x is 9 l>ge measure because a cli5t has /rong p]sonal motivation1 a /rong w4 ,h[ev]1 "s approa*es to !rapy dep5d m heavily ?an o!rs on a cli5t's /r5g? ( det]m9ation4 ,!y include3 ,m1 ,o1 ,e1 ,p1 ,i1 ,n1 ,h1 ,a1 ,x1 ,t #b ,commitm5t to ! ,process ( ,!rapy ,d y believe y c commit y\rself to !rapy t spans _m mon?s & sometimes sev]al ye>s8 ,if y hope to ga9 long-la/+ b5efits f y\r exp]i5ce 9 !rapy1 y w ne$ to commit y\rself to c]ta9 practices & ways ( ?9k+ aft] =mal !rapy has end$4 ,d y feel t y h ?is k9d ( t5acity & ability to foll[ ?r\gh8 ,^! are bo? qualities relat$ to self-discipl9e1 b !y h m to d ) su/a9+ a process ov] a long p]iod ( "t3 9 a ^w1 commitm5t4 ,d y feel y c develop a /rong s5se ( commitm5t to long-t]m !rapy8 ,a ,to a long-range plan = life improvem5t8 ,h1 ,m #ha #c ,pati5ce ,if y are suff]+ f incapacitat+ anxiety or depression1 be+ pati5t ab\t ! process ( !rapy c be v dem&+4 ,long-t]m !rapies require m pati5ce1 endurance1 & tol]ance ?an d %ort-t]m !rapies4 ,are y able to put y\r tru/ 9 a process :]e results are notic$ only v gradually8 7,if n1 y may feel t :at is mo/ urg5t n[ is to obta9 prompt relief f symptoms--see ! ,summ>y ( ,ma9 ,approa*es to ,psy*o!rapy1 at ! end ( ?is *apt]1 to get "s idea ( ! av]age durations ( ! diff]5t !rapies47 ,!rapies especially requir+ pati5ce--) y\rself1 ) ! *all5ge1 or ) ! duration ( !rapy--include3 ,a1 ,h1 ,m1 ,x #d ,initiative ,"s approa*es to !rapy (f] v little direction or specific advice f ! !rapi/4 ,d y feel t y h ! initiative to proce$ )\t explicit direction f ! !rapi/8 ,if s1 :at y probably ne$ 9 a !rapi/ is prim>ily ! capacity to und]/& y well1 to accept y z a p]son1 & to enc\rage y 9 a w>m & positive way to d :at y ?9k is be/3 ,b #e ,tol]ance to ,fru/ration ,d y h a fairly high ?re%old ( fru/ration :5 y\r beliefs & ideas are *all5g$8 ,:5 y d n imm$iately get :at y want1 c y tol]ate fairly well :at may seem l a long r\te to get :]e y want to g8 7,d y cope well ) ! fru/ration ( gett+ lo/ 9 y\r c>1 = example87 ,c y tol]ate1 )\t s]i\s irritation1 ang]1 or hurt1 be+ pu%$ to confront "s ( ! pret5ses or di/ortions or illusions y may h liv$ by8 ,c y accept1 ) "s calmness ( m9d1 hav+ someone po9t out to y t y h n be5 z cle> ab\t ?+s z y ?\ght1 & t sometimes y\r attitudes are n consi/5t1 t y are1 to "s ext5t1 confus$8 ,a1 ,c1 ,e1 ,p #f ,rigidity ,d y (t5 f9d y\rself try+ to be1 or wi%+ y 7 someone y're n8 ,c #hb ,are y p]fectioni/ic8 ,upset :5 y make ev5 fairly m9or mi/akes8 ,conc]n$ t ?+s be 9 _! prop] place8 ,are y frequ5tly int5se & uptight8 ,c1 ,j ,are y ov]controll+--anxi\s :5 y d n feel y h ?+s cle>ly "u control8 ,are y depress$ 7see #e1 ,table #a7 or phobic 7see #d4b1 ,table #a78 ,d y suspect t o!r p ?9k t y magnify evils1 bl[+ negative ?+s out ( proportion8 ,are y incl9$ to be morali/ic1 dogmatic1 critical1 or judgm5tal8 ,are y an uncompromis+ p]son8 ,d y feel1 deep d[n1 t p]haps y\r expectations & dem&s 7conc]n+ o!rs1 y\rself1 & ! _w7 may be unreali/ic8 ,d y ?9k y are (t5 incl9$ to confuse :at y w\ld l ) :at y ne$8 ,e1 ,p1 ,h #g ,inhibition ,d y feel block$1 inhibit$1 or held 9 *eck by an ov]ly critical self8 ,b ,d y feel t y h p5t-up feel+s t are 9 ne$ ( release8 ,d y feel /ultifi$ or oppress$ by y\r relation%ips ) y\r sp\se1 fri5ds1 or family8 ,does y\r life lack emotional int5sity8 ,d y obta9 little joy or satisfaction f liv+8 ,c1 ,j ,d y feel t someh[ !re are blocks 9 y t are /&+ 9 ! way ( y\r self-realization1 ( fulfill+ y\r pot5tial8 ,h #h ,introv]sion or ,extrov]sion ,are y inn]-direct$8 ,w\ld y r be alone or ) "o or two fri5ds ?an att5d a p>ty8 ,are y impati5t1 or d y ev5 res5t receiv+ unsolicit$ sugge/ions8 ,a1 ,f ,on ! o!r h&1 are y at ease ) gr\ps ( p8 ,is x important to y\r self-image :at o!r p ?9k ( y8 7,are y p]haps /atus-ori5t$87 ,d y (t5 f9d x useful or helpful to receive advice8 ,q #i ,motivation & ,capacity = ,physical ,ex]cise ,are y free ( physical h&icaps8 ,d y l to be physically active1 to ex]cise8 #hc ,d y beg9 to feel re/less :5 a week or m goes by & y h be5 s$5t>y8 ,if y are n physically fit n[ b are heal?y1 does x appeal to y to "w regul>ly & h>d to become physically /rong] & to improve y\r endurance8 ,t1 ,j1 yoga 7see ,u7 #aj ,ne$ = ,acceptance1 ,human ,w>m?1 & ,g5tle ,enc\ragem5t ,d y feel t p]haps no "o has ev] tak5 ! "t to li/5 to y1 to take a g5u9e int]e/ 9 y & 9 y\r problems z a p]son8 ,d y feel1 p]haps because ( circum/ances or problems ov] :i* y've _h no control1 t y h receiv$ r little human w>m? f o!rs8 ,w\ld y pref] enc\ragem5t t is pati5t & w>m r ?an a =ceful pu% to *ange y\r life8 ,b #aa ,articulat5ess & ,analytical ,attitude ,c y talk op5ly & cle>ly ab\t y\r feel+s1 ab\t :at is tr\bl+ y8 ,c y fairly readily describe examples ( situations t may bo!r y8 ,if y 7 ask$ to describe ! p]sonality 7n 8 or h] physical features & behavior7 ( someone y talk$ ) la/ night = half an h\r at a p>ty1 c\ld y d ?is )\t a lot ( hesitation & br[-furr[+8 ,d y l to talk ab\t p]sonal problem solv+1 ab\t y\r feel+s1 pa/ ev5ts1 & :y y h come to feel z y d8 ,d y feel a ne$ to acquire an ov]all s5se ( und]/&+ ( y\rself1 y\r family1 & h[ !y h influ5c$ y8 ,a #ab ,reflectiv5ess ,d y (t5 f9d y\rself ?9k+ ab\t y\r feel+s1 ab\t ! purpose ( life1 & ab\t :e!r y\rs has a mean+ful direction8 ,d y t5d to come home f a visit ) fri5ds or family & g ov] 9 y\r m9d :at w5t on & wond] :y p said & did c]ta9 ?+s8 ,d y h a m5tal habit ( /&+ ap>t f :at y're do+ & judg+ y\rself & y\r "w8 ,d y sp5d mu* "t j ?9k+ ab\t ?+s1 ev5 dwell+ on problems t conc]n y8 ,a1 ,g #hd #ac ,imag9ation ,z a *ild1 did y h an imag9>y fri5d8 ,:5 y sit on a rock by a brook 9 ! woods1 d y quickly beg9 to feel a special s5se ( relaxation8 ,or1 wat*+ ! waves break+ on ! bea*1 d y f9d y\rself lull$ into a s5se ( absorption 9 nature8 ,d y enjoy read+8 ,z y read a descriptive novel1 d y t5d to see _m ( ! places & p8 ,d ! ev5ts come alive = y8 ,d y f9d y\rself ?9k+ ab\t ! ev5ts 9 ! book z ?\gh !y make up a real _w ( _! own8 ,w #ad ,s5sitivity to ,values ,are p]sonal values v important to y8 ,= example1 d y sometimes f9d y\rself ?9k+ t s mu* ( television programm+ is m$iocre1 tra%1 a wa/e ( "t8 ,d y feel t !re are human values t are m important ?an h[ mu* money y make1 :at model c> y drive1 & ! luxuri\sness ( y\r home8 ,are y a religi\s or spiritual p]son1 :e!r y att5d *ur* or n8 ,d y l art1 music1 or lit]ature8 ,d y feel1 really feel1 a s5se ( compassion or empa?y = p :o face pov]ty & mis=tune8 ,d y sometimes feel guilty because ( y\r own situation1 t !re always seem to be o!rs :o are worse (f8 ,h y ev] fac$ ! opportunity to take advantage ( someone or ( a situation & simply decid$ n to 7ev5 ?\gh y knew y c\ld d ?is )\t risk7 because y simply want$ to feel hone/ or reta9 a s5se ( y\r own integrity8 ,are y 9 se>* ( a ri*] mean+ 9 life8 ,d y wond] :e!r :at y are do+ ) y\r life is really "r = y8 ,g #ae ,com=t 9 a ,gr\p ,sett+ ,d y feel com=table & safe 9 gr\ps8 ,d y feel fri5dly :5 y pass a h\se :]e a p>ty is go+ on8 ,d y enjoy p>ties or social ga!r+s8 ,did y come f a family ) sev]al *ildr58 ,q1 ,c #he #af ,sev]e ,impairm5ts ,d y h any le>n+ or communication disabilities8 ,are y s tr\bl$ because ( emotional upheaval t y _c "w or ma9ta9 y\r family responsibilities8 ,d y h any addictions t are caus+ grief = y or o!rs close to y8 ,d y sometimes h to let (f /eam1 ev5 ?\gh y "k y are hurt+ o!rs1 damag+ _! prop]ty1 or injur+ y\rself8 #hf ,,/ep #c ,,table #c3 ,,! ,,approa*es ,,to ,,!rapy ,,discuss$ ,,9 ,,?is ,,book ,9 ! left column are ! lett]s us$ 9 ?is *apt] to id5tify ea* approa* to !rapy3 ,lett] ,code ,approa* to ,!rapy ,*apt] ,a ,psy*oanalysis #i ,b ,cli5t-c5t]$ !rapy #aj ,c ,ge/alt !rapy #aj ,d ,transactional analysis #aj ,e ,rational-emotive !rapy #aj ,f ,exi/5tial-humani/ic !rapy #aj ,g ,logo!rapy #aa ,h ,reality !rapy #aa ,i ,adl]ian !rapy #aa ,j ,bio5]getics #aa ,emotional ,k ,primal !rapy flood+ #aa !rapies ,l ,implosive !rapy #aa ,m ,direct decision !rapy #aa ,n ,c\nt]-condition+ #ab ,o ,behavior modification ,behavioral #ab psy*o!rapies ,p ,cognitive approa*es to behavior *ange #ab ,q ,gr\p !rapy #ac ,r ,m>riage !rapy #ad ,s ,family !rapy #ad ,t ,!rapeutic ex]cise #ae ,u ,bi(e$back #ae #hg ,v ,relaxation tra9+ #ae ,w ,hypnosis #ae ,x ,m$itation #ae ,y ,drug !rapy #af ,z ,nutrition !rapy #ae ,,h[ ,,to ,,use ,,! ,,in=mation ,,y ,,n[ ,,h ,if y h foll[$ ! in/ructions = ,/eps #a1 #b1 & #c1 y %\ld h id5tifi$ a pot5tially promis+ !rapy1 or gr\p ( !rapies1 9 relation bo? to y\r goals or problems & to y\r own e/imation ( c]ta9 important traits ( y\r p]sonality or "*4 ,! !rapy or approa*es to !rapy y h id5tifi$ n[ ne$ to be te/$1 fir/1 9 y\r imag9ation z y read ! *apt]s ( ?is book1 :i* w give y an idea ( :at ea* major approa* to !rapy is l1 & !n1 if y decide to proce$1 9 reality1 :5 y h locat$ a suitable !rapi/ 7see ,*apt] #ag74 ,! ne$ = ?is te/+ is a matt] ( simple realism3 y n[ h a s5se ( direction1 or p]haps sev]al alt]native directions1 to consid]4 ,! approa* to self-diagnosis describ$ 9 ?is *apt] is int5d$ to be useful1 b x is n infallible2 mu* dep5ds on ! accuracy ( y\r problem diagnosis1 ! appropriat5ess ( ! goals y h set1 & y\r self-und]/&+4 ,mu* also w dep5d on ! !rapi/ y locate & h[ well y are able to "w toge!r4 ,! recomm5d$ !rapies li/$ by lett] codes = ,/eps #a & #b reflect evaluations f sev]al s\rces3 7#a7 ,!rapi/s !mselves claim t c]ta9 approa*es favor$ by !m h be5 %[n to be useful = treat+ c]ta9 problems1 = realiz+ c]ta9 goals1 & = cli5ts ) c]ta9 p]sonal qualities4 7#b7 ,v>i\s /udies also h attempt$ to demon/rate = :at & sometimes = :om _m ( ! major !rapies are mo/ successful 7see ,*apt] #bj74 7#c7 ,prim>ily 9 ! ord]+ ( lett] codes 9 connection ) ! specific #hh goals1 problems1 & p]sonal qualities li/$ 9 ,/eps #a & #b1 ,i h reli$ on my own exp]i5ce & judgm5t4 ,lett] codes li/$ fir/ designate !rapies t1 9 g5]al1 are commonly reg>d$ by !rapi/s & psy*ologi/s z mo/ useful4 ,at times1 :5 g5]al cons5sus appe>$ to be lack+1 ,i h us$ my own evaluation4 ,! int5tion 9 ?is *apt] is to make explicit a simple & reasonable process ( *oos+ a !rapy4 ,_m !rapies are n m5tion$ 9 connection ) specific goals1 problems1 or p]sonality traits4 ,to be sure1 "s ( ! !rapies t are n m5tion$ c be useful to c]ta9 individuals :o h a giv5 goal1 problem1 or trait4 ,b ! objective ( ?is book is to improve ! g5]al reliability ( a p]son's self-diagnosis & self-und]/&+4 ,! book is a guide1 n a bible4 ,,comb9+ ,,approa*es ,!re is evid5ce t comb9+ two !rapies = c]ta9 problems c frequ5tly be m effective ?an us+ ei!r 9 isolation4 ,treatm5t = individuals suff]+ f sev]e anxiety or depression (t5 w comb9e drug !rapy1 = example1 ) "o ( ! f\rte5 approa*es to !rapy describ$ 9 ,*apt]s #i-ab & #ad 7& li/$ bel[1 "u ,a74 ,or1 individuals :o h problems due to excessive /ress may1 = example1 be advis$ to comb9e bi(e$back1 relaxation tra9+1 hypnosis1 m$itation1 or ex]cise !rapy ) a =m ( psy*o!rapy4 ,usually1 :5 !rapies are comb9$1 "o is a =mal psy*o!rapy & ! o!r is an adjunctive !rapy--t is1 a !rapy t mo/ (t5 is n reli$ on exclusively4 ,"s adjunctive !rapies l5d !mselves v well to use by individuals on _! own4 ,comb9$ treatm5ts t5d1 !n1 to employ "o approa* tak5 f li/ ,a & "o f li/ ,b3 ,a 7,ma9 ,!rapies7 ,psy*oanalysis ,cli5t-c5t]$ !rapy ,ge/alt !rapy ,transactional analysis ,rational-emotive !rapy ,exi/5tial-humani/ic !rapy #hi ,logo!rapy ,reality !rapy ,adl]ian !rapy ,direct decision !rapy ,behavior modification ,cognitive approa*es to behavior *ange ,m>riage & family !rapy ,b 7,adjunctive ,!rapies7 ,drug !rapy ,m$itation ,hypnosis ,relaxation tra9+ ,bi(e$back ,!rapeutic ex]cise ,approa*es ,t ,may ,appe> ,"u ,ei!r ,a or ,b ,bio5]getics ,primal !rapy ,implosive !rapy ,c\nt]-condition+ ,gr\p !rapy #ij ,a ,,summ>y ,,( ,,! ,,ma9 ,,approa*es ,,to ,,psy*o!rapy ,av]age ,!rapy ,be/ ,suit$ ,=3 ,duration99 ,co/9999 ---------------------------------------- ---------------------- ,cli5t's ,p]sonality 7n all traits may apply to a ,problems or ,goals s+le p]son7 ---------------------------------------- ---------------------------------------- ----------------------------- 99 #a ,brief !rapies1 frequ5tly #ab weekly sessions or less2 #b #c-f mon?s2 #c long-t]m !rapies1 #f mon?s to sev]al ye>s 9999 initially exp5sive1 !n #aj-be_/;hr42 exp5sive #ej-ajj_/;hr42 mod]ate1 #be-ej_/;hr42 #j inexp5sive1 #aj-be_/;hr42 (t5 available on a slid+ scale basis 7see ,*apt] #d7 ?r\gh c\nty cl9ics1 ag5cies etc ,a4 ,psy*oanalysis self-developm5t3 broad-spectrum self-discipl9$ #c improvem5ts committ$ suff]+ f *ildhood traumas pati5t fe> ( )drawal ( affection tol]ant to fru/ration & ( ab&onm5t introv]t$ int]p]sonal problems articulate phobias analytical compulsions reflective sexual disord]s depression mania manic depression psy*oses ,b4 ,cli5t-c5t]$ self-developm5t3 broad-spectrum inhibit$ #b improvem5ts possess+ initiative l[ self-wor? ne$+ acceptance1 crisis int]v5tion human w>m?1 & g5tle enc\ragem5t ,c4 ,ge/alt behavior problems 9 *ildr5 tol]ant to fru/ration #a-b to #j %yness_/passivity rigid cop+ ) p]sons 9 au?ority inhibit$ psy*osomatic disord]s able to "w 9 a gr\p adju/m5t problems3 m9orities sett+ & ! poor family conflicts crisis int]v5tion #ia ,d4 ,transactional %yness_/passivity int]e/$ 9 effective #a-b #j analysis lonel9ess_/empt9ess communication ho/ility_/ov]be>+ p]sonality fe> ( )drawal ( affection & ( ab&onm5t improv+ effectiv5ess ( communication cop+ ) p]sons 9 au?ority phobias adju/m5t problems m>ital problems1 especially ^? involv+ communication difficulties family conflicts drug abuse ,e4 ,rational- ho/ility_/ov]be>+ self-discipl9$ #b emotive p]sonality rigid int]p]sonal problems anxiety disord]s po/-traumatic /ress phobias compulsions sexual disord]s impulse control disord]s depression mania & manic depression adju/m5t problems m>ital problems del9qu5cy & crim9al behavior #ib ,f4 ,exi/5tial- lonel9ess_/empt9ess introv]t$ #b humani/ic loss ( fai? 9 y\rself1 s5sitive to exi/5tial 9 o!rs1 or 9 life's purpose issues inability to accept life's limitations crisis int]v5tion ,g4 ,logo!rapy e/rangem5t_/ali5ation f reflective #b o!rs s5sitive to values loss ( fai? 9 y\rself1 9 o!rs1 or 9 life's purpose nog5ic neuroses depression due to value conflicts inability to accept life's limitations emotional problems 9 fac+ old age problems ( ! rec5tly wid[$ /utt]+ %ak+ & motor tic disord]s crisis int]v5tion ,h4 ,reality desire = a success-id5tity self-discipl9$ #a-b anxiety disord]s committ$ po/-traumatic /ress pati5t adju/m5t problems rigid m>ital problems problems ( ! rec5tly wid[$ vocational problems del9qu5cy & crim9al behavior psy*oses #ic ,i4 ,adl]ian deep disc\ragem5t ) life self-discipl9$ #a-b m>ital problems inhibit$ family conflicts /utt]+ %ak+ & motor tic disord]s vocational problems del9qu5cy & crim9al behavior ,j4 ,bio5]getics self-developm5t3 broad-spectrum inhibit$ #a-b improvem5ts motivat$ & able to suff]+ f *ildhood pa9 und]take physical ex]cise ,k4 ,primal anxiety disord]s p5t-up feel+s #a-b po/-traumatic /ress phobias compulsions drug abuse ,l4 ,implosive phobias 7nonspecific7 #a ,m4 ,direct decision desire = a success-id5tity self-discipl9$ #a compulsions committ$ impulse control disord]s pati5t vocational problems adju/m5t problems psy*oses drug abuse #id ,n4 ,c\nt]- %yness_/passivity self-discipl9$ #a-b condition+ ho/ility_/ov]be>+ p]sonality phobias psy*osomatic disord]s sexual disord]s adju/m5t problems m>ital problems family conflicts crisis int]v5tion ,o4 ,behavior m5tal ret>dation self-discipl9$ #a-b modification autism possibly impair$ behavior problems 9 *ildr5 hyp]k9etic behavior del9qu5cy & crim9al behavior eat+ disord]s compulsions sexual disord]s impulse control disord]s /utt]+ crisis int]v5tion psy*oses #ie ,p4 ,cognitive int]p]sonal problems self-discipl9$ #a-b approa*es anxiety disord]s rigid to behavior po/-traumatic /ress *ange psy*osomatic disord]s sexual disord]s depression mania & manic depression adju/m5t problems m>ital problems crisis int]v5tion ,q4 ,gr\p %yness_/passivity extrov]t$ #a #j lonel9ess_/empt9ess tol]ant to gr\p ho/ility_/ov]be>+ involvem5t p]sonality improv+ communication effectiv5ess impulse control disord]s ,r4 ,m>riage m>ital problems supportive !rapy = individual 7nonspecific7 #a-b problems fe> ( )drawal ( affection & ( ab&onm5t ,s4 ,family family conflicts 7nonspecific7 #a-b supportive !rapy = individual problems emotional di/urbances 9 *ildr5 fe> ( )drawal ( affection & ( ab&onm5t family-bas$ compulsions psy*oses #if ,t4 ,!rapeutic depression self-discipl9$ #b-c #j or ex]cise anxiety disord]s motivat$ & able to no po/-traumatic /ress und]take physical co/ m>ital problems ex]cise alcoholism drug abuse smok+ psy*oses ,u4 ,bi(e$back physical pa9 & disability 7nonspecific7 #a-b %ak+ & motor tic disord]s /utt]+ insomnia anxiety disord]s po/-traumatic /ress phobias depression ,v4 ,relaxation anxiety disord]s 7nonspecific7 #a-b tra9+ po/-traumatic /ress phobias physical pa9 & disability insomnia #ig ,w4 ,hypnosis emotional di/urbances 9 imag9ative #a-b *ildr5 tru/+ eat+ disord]s int]p]sonal problems anxiety disord]s po/-traumatic /ress phobias psy*osomatic disord]s sexual disord]s depression mania & manic depression physical pa9 & disability /utt]+ %ak+ & motor tic disord]s ,x4 ,m$itation loss ( fai? 9 y\rself1 9 self-discipl9$ #c #j or o!rs1 or 9 life's purpose pati5t no anxiety disord]s co/ po/-traumatic /ress depression mania & manic depression physical pa9 & disability alcoholism drug abuse smok+ #if ,y4 ,drug autism possibly impair$ #a-c hyp]k9etic di/urbances anxiety disord]s po/-traumatic /ress phobias compulsions sexual disord]s depression mania & manic depression physical pa9 & disability %ak+ & motor tic disord]s insomnia crisis int]v5tion ,z4 ,nutrition possibly hyp]k9etic behavior no data available -- -- z well z o!r problems 7see ,*apt] #ad7 99 #a ,brief !rapies1 frequ5tly #ab weekly sessions or less2 #b #c-f mon?s2 #c--long-t]m !rapies1 #f mon?s to sev]al ye>s 9999 initially exp5sive1 !n #aj-be_/;hr42 exp5sive #ej-ajj-;f_/hr42 mod]ate1 #be-ej_/;hr42 #j inexp5sive1 #aj-be_/;hr42 (t5 available on a slid+ scale basis 7see ,*apt] #d7 ?r\gh c\nty cl9ics1 ag5cies1 etc4 #ii #h ,,emotional ,,problems ,,t ,,may ,,h ,,physical ,,causes ,?is *apt] has a s+le important purpose3 to p]suade y1 if y are 9 s]i\s emotional di/ress1 to h a compreh5sive physical exam9ation be=e beg9n+ psy*o!rapy4 ,imag9e h[ di%e>t5$ & fru/rat$ y might feel aft] a p]iod ( unsuccessful !rapy1 only to f9d out aft]w>d t y\r problems c\ld be trac$ to a physical cause4 ,x is ess5tial t y elim9ate ! possibility ( a physical basis = y\r problems be=e seek+ !rapy4 ,9 fact1 mo/ !rapi/s r\t9ely recomm5d t y h a complete physical be=e ent]+ !rapy4 ,re/ assur$ t do+ s w n be a wa/e ( "t4 ,ri*>d ,rada1 ,director ( ,college ,hospital 9 ,c]ritos1 ,cali=nia1 e/imates t betwe5 five & t5 p]c5t ( cli5ts ) depression1 anxiety1 or unusual ?\ghts & behavior may h und]ly+ physical conditions t are responsible1 includ+ gl& #ajj dysfunction1 an epileptic abnormality1 he>t disease1 canc]1 & s on4 ,! foll[+ facts1 too1 %\ld conv9ce y t hav+ a compreh5sive physical is p>am\nt3 99 ,z _m z "o pati5t 9 e t5 :o suff] f s]i\s depression has a ?yroid disord]4 99 ,"o p]son 9 e f\r :o are diagnos$ z hav+ psy*iatric disord]s & :o are ov] sixty-five has an und]ly+ physical illness t is responsible4 99 ,an equal numb] ( individuals ov] sixty-five h emotional problems t are made worse by und]ly+ physical disord]s4 99 ,?ree p]c5t ( p :o regul>ly take prescription m$ication develop m5tal symptoms4 ,dr4 ,leon>d ,small1 a speciali/ 9 ! field ( neuropsy*odiagnosis1 has f\nd t ! m sev]e emotional or m5tal symptoms are1 ! m likely x is t !rapi/s 7& pati5ts7 w ov]look ! possibility ( und]ly+ physical disord]s4#a #a ,leon>d ,small1 ,neuropsy*odiagnosis 9 ,psy*o!rapy 7,new ,york ,brunn]_/,mazel1 #aihj71 p4 vii4 ,x isn't necess>y or possible to give a detail$ or compreh5sive catalog ( physical causes ( emotional & m5tal di/urbances "h1 b x may be helpful to _m p to see "s ( ! pr9cipal ways 9 :i* psy*ological symptoms c be produc$ by physical problems4 ,hopefully1 ^! illu/rations w p]suade y1 if y are emotionally or m5tally tr\bl$1 ( ! wisdom ( a ?or\gh physical4 ,x is a small price to pay if emotional symptoms c be trac$ to a physical cause4 ,x is well kn[n t virtually any s]i\s organic illness or injury c produce emotional suff]+1 ei!r 9 ! =m ( physical pa9 or 9 ! =m ( anxiety & depression4 ,*ronic pa9 is a *ronic /ress & c lead to ! same emotional problems z prolong$ /ress ( any v>iety3 anxiety or depression4 ,simil>ly1 prolong$ sev]e anxiety or depression c cause physical det]ioration & make ! body m susceptible to disease4 #aja ,!re are1 !n1 two vici\s circles1 or fe$back loops1 t c play a role 9 caus+ or aggravat+ emotional di/urbance3 ,illu/ration3 ,! two vici\s circle or fe$back loops t may exi/ betwe5 physical disord]s & emotional di/urbances ,9 ! fir/ loop1 an und]ly+ physical disord]1 :i* may be a disease or a physical injury1 leads to emotional symptoms 7& v likely to physical symptoms z well1 al?\gh ^! may n be z pron\nc$74 ,h[ev]1 ! emotional reactions t are produc$ c !mselves make ! physical disord] worse1 & c]ta9ly emotional di/urbance makes liv+ ) & treat+ ! und]ly+ physical disord] m difficult4 ,9 ! second loop1 emotional di/urbances cause c]ta9 physical disord]s3 a peptic ulc]1 he>t palpitations1 ulc]ative colitis1 backa*e1 hyp]t5sion1 or high blood pressure1 etc41 & may pr$ispose c]ta9 individuals to ar?ritis1 canc]1 or diseases ( ! immune sy/em4 ,once a psy*osomatic l9k has be5 e/abli%$ betwe5 a tr\bl$ m9d & ! body1 & an organic disord] has come ab\t1 ! physical disord]1 9 turn1 c produce /rong] or m exagg]at$ emotional reactions4 ,anxiety or depression may increase because ! p]son is n[ bo? physically ill & emotionally tr\bl$4 ,^! two s-call$ positive fe$back loops c obvi\sly #ajb lead to a runaway process t becomes worse & worse4 ,psy*osomatic m$ic9e focuses on ! second ( ^!2 our focus "h is on ! fir/3 physical orig9s ( emotional di/urbance4 ,und]ly+ physical disord]s ( ?is k9d include metabolic diseases1 disord]s & diseases affect+ ! bra9 & n]v\s sy/em1 head injuries1 o!r physical disord]s & conditions1 infecti\s diseases1 reactions to m$ication1 & drug addiction & alcoholism4 ,ea* is discuss$ 9 ! rema9d] ( ?is *apt]4 ,,metabolic ,,diseases ,sev]al well-kn[n metabolic diseases c lead to emotional di/urbances3 ,,hyp]?yroidism ,an ov]active ?yroid1 kn[n z hyp]?yroidism1 is usually caus$ by ! pituit>y gl&'s ov]production ( a hormone call$ ,,t%1 or ?yroid-/imulat+ hormone4 ,?is causes ! ?yroid1 a butt]fly-%ap$ gl& 9 ! l[] "p ( ! neck1 to produce an excess ( ! ?yroid hormone ?yrox9e4 ,hyp]?yroidism is eight times m common 9 wom5 ?an 9 m54 ,! emotional symptoms ( hyp]?yroidism include a m int5se & *ronic n]v\sness ?an 9 hypo?yroidism 7discuss$ bel[71 ov]reactions to m9or crises1 mood9ess1 frequ5t fe> )\t kn[+ :y1 a s5se ( agitation1 dread1 & occasionally trembl+ or %ak+4 ,"s pati5ts ) s]i\s hyp]?yroidism may h symptoms resembl+ ^? ( s*izophr5ia1 9 :i* !re is little or no contact ) reality4 ,physical symptoms include rapid loss ( weight1 unusual appetite1 rapid pulse1 di>rhea1 & muscle weakness 7especially 9 ! legs1 z :5 climb+ /airs74 ,! classical symptoms ( hyp]?yroidism are />+ eyes & enl>gem5t ( ! neck1 b ^! ne$ n be pres5t4 ,x is int]e/+ to note t c]ta9 factors 9 upbr++ & p]sonality seem to pr$ispose p to hyp]?yroidism 7?is w\ld mean t a fe$back loop ( ! second type may precipitate ! disease 9 "s p74 ,individuals :o lat] develop hyp]?yroidism (t5 h ^! *>act]i/ics3 #ajc 99 ,!y 7 =c$ prematurely to become self-suffici5t & responsible4 99 ,!y felt reject$ by "o or bo? p>5ts & fe>$ a loss ( emotional support4 99 ,_! e>ly dep5d5ce ne$s 7_! ne$s = affection1 mo!r+1 w>m?1 etc47 7 fru/rat$1 & ?is l$ to feel+s ( insecurity & l[ self-e/eem & to ! belief t ! _w is a ?reat5+ place4 99 ,!y (t5 _h dom9ant1 tight-lipp$1 ov]controll+ mo!rs4 ,,hypo?yroidism ,an und]active ?yroid1 kn[n z hypo?yroidism1 is caus$ by an inadequate production ( ?yroid hormone4 ,x is mo/ common 9 middle-ag$ wom54 ,! emotional symptoms ( hypo?yroidism include m5tal sluggi%ness1 n]v\sness1 depression1 irritability1 impati5ce1 & frequ5tly dislike ( ev]yday activities4 ,physical symptoms include a s5se ( heav9ess & le?>gy1 dry sk91 s5sitivity to cold1 con/ipation1 & ?9n+ hair4 ,,hyp]- ,,& ,,hypop>a?yroidism ,! p>a?yroid gl&s1 :i* are f\r bean-size gl&s locat$ on top ( ! ?yroid gl&1 manufacture hormones t regulate phosphorus & calcium levels 9 ! body4 ,excess hormone raises ! calcium level too high1 & psy*otic-l behavior c result4 ,too little hormone l[]s ! calcium level to ! po9t t a p]son may behave l an alcoholic4 ,^! conditions are comp>atively r>e4 ,,diabetes ,diabetes1 or hypo9sulism1 :i* at ! "t ( ?is writ+ affects z _m z #b4e million ,am]icans1 results f und]production ( insul91 :i* 9 turn causes an excess ( sug> 9 ! blood & ur9e4 ,diabetes takes two =ms3 juv5ile onset 7or insul9-dep5d5t7 & adult onset 7or non9sul9-dep5d5t7 diabetes4 ,! fir/ type />ts 9 *ildhood or "y adul?ood1 & is caus$ by ! body's failure to produce en\gh insul94 ,juv5ile onset diabetes is #ajd usually controll$ by means ( regul> injections ( insul94 ,adult onset diabetes is less s]i\s ?an juv5ile diabetes2 x occurs m (t5 9 ! eld]ly & especially 9 p :o are ov]weight4 ,diabetes c appe> 9 a p]son aft] a traumatic ev5t3 great /ress1 a physical accid5t1 surg]y1 infection1 or a sev]e emotional di/urbance4 ,x may also appe> aft] a p]son has gone ?r\gh a long p]iod ( fatigue1 depression1 indecision1 or s5se ( hopelessness4 ,^? :o become diabetic may be individuals :o felt /rong res5tm5t t[>d _! p>5ts :ile gr[+ up or :o 7 spoil$ *ildr54 ,diabetic m5 (t5 7 dom9at$ by _! mo!rs :ile be+ excessively dep5d5t on !m4 ,adult onset diabetes is usually controll$ )\t insul9 injections1 p>ticul>ly dur+ ! e>ly /ages ( ! disease4 ,treatm5t 9 ab\t "o-?ird ( non9sul9-dep5d5t diabetics is possible by diet alone2 9 o!rs1 x is necess>y to take oral hypoglycemic drugs t /imulate ! release ( insul94 ,! emotional symptoms ( bo? =ms ( diabetes may include apa?y1 depression1 p]sonality disord]s1 or ev5 psy*osis z a result ( und]secretion ( insul94 ,physical symptoms include ! ne$ to ur9ate frequ5tly1 day & night1 unusual fatigue & weakness1 t+l+ 9 h&s & feet1 r$uc$ resi/ance to infections 7especially ( ! ur9>y tract71 blurr$ vision1 impot5ce 9 m51 & lack ( m5/rual p]iods 9 wom54 ,,hypoglycemia ,hypoglycemia1 or hyp]9sulism1 :i* affects p]haps z _m z five million ,am]icans1 is caus$ by ov]production ( insul94 ,excess insul9 leads to l[ blood sug> 7lit]ally1 hypoglycemia74 ,sometimes ?is ov]production ( insul9 is caus$ by a tumor ( ! pancreas2 ! gr[? c (t5 be remov$ surgically to correct ! condition4 ,! emotional symptoms ( hypoglycemia include depression & anxiety4 ,physical symptoms include fa/ pulse1 palpitations1 dizz9ess1 g5]al weakness1 fa9tness1 /oma* pa91 blurr$ vision1 & sweat+4 ,^! symptoms (t5 occur a few h\rs aft] eat+ & disappe> aft] eat+ aga94 #aje ,hypoglycemia has become almo/ a fad disease among psy*onutritioni/s4 ,! condition is believ$ by mo/ physicians1 h[ev]1 to be conf9$ ma9ly to diabetics :o h n kept to a prescrib$ r\t9e & h all[$ _! levels ( insul9 to become too high4 ,sometimes /oma* surg]y1 liv] disease1 pregnancy1 & p]iods ( high fev] c cause attacks ( hypoglycemia4 ,,disord]s ,,& ,,diseases ,,affect+ ,,! ,,bra9 ,,& ,,n]v\s ,,sy/em ,,epilepsy ,! second mo/ common physical cause ( emotionally di/ress+ symptoms1 aft] ! metabolic disord]s we h j discuss$1 is epilepsy4 ,approximately #g p]c5t ( m5tally di/urb$ pati5ts h "s =m ( epilepsy4 ,epilepsy affects betwe5 #a & #b p]c5t ( ! ,u4,s4 population4 ,( p :o h epilepsy1 two-?irds appe> to h no /ructural abnormality ( ! bra92 9 ! rema9+ ?ird1 ! disease c be trac$ to bra9 damage at bir?1 a sev]e head injury1 an infection t caus$ bra9 damage1 or a bra9 tumor4 ,! emotional symptoms ( epilepsy c involve ei!r anxiety or depression or bo?4 ,once a p]son has _h a convulsive seizure1 he or %e may live 9 con/ant appreh5sion t ano!r seizure w occur4 ,!re may be occasional1 transi5t feel+s ( unreality4 ,physical symptoms include peculi> /oma* s5sations1 di/ort$ vision1 occasional biz>re behavior su* z laugh+ = no app>5t reason or sudd5 & unprovok$ ang]1 loss ( consci\sness1 & convulsions4 ,,p>k9sonism ,p>k9son's disease (t5 causes anxiety or depression4 ,physical symptoms e>ly 9 ! c\rse ( ! disease include sl[+ ( movem5t & inability to write "o's "n )\t ! h&writ+ becom+ small] & small]4 ,lat] symptoms include tremors1 muscle /iffness or rigidity1 n]v\sness1 & t5sion4 #ajf ,,multiple ,,scl]osis ,multiple scl]osis usually beg9s 9 p betwe5 ! ages ( tw5ty & =ty1 affect+ slightly m wom5 ?an m54 ,symptoms may disappe> aft] "o or a numb] ( attacks1 or !y may get progressively worse & cause sev]e disability4 ,emotional symptoms include anxiety1 panic attacks1 & depression4 ,physical symptoms may involve a feel+ ( numbness or t+l+ affect+ "o limb or "o side ( ! body1 tempor>y blurr+ ( vision1 slurr$ spee*1 & difficulty or lack ( control 9 ur9at+4 ,,bra9 ,,tumors ,bra9 tumors may cause sev]e heada*es1 blurr$ or d\ble vision1 vomit+ )\t ! w>n+ ( nausea1 g5]al weakness1 &1 9 "s cases1 epileptic seizures4 ,emotional symptoms may involve n]v\sness1 irritability1 memory problems1 & p]sonality *anges4 ,,head ,,injuries ,head injuries t damage ! bra9 g5]ally cause heada*es & dizz9ess4 ,emotional symptoms usually involve n]v\sness & sometimes confusion4 ,9 m s]i\s injuries1 !re may be loss ( memory1 depression1 & decreas$ al]tness4 ,sev]e damage to ! bra9 c cause unconsci\sness t may p]si/ = days or weeks4 ,,o!r ,,physical ,,disord]s ,,& ,,conditions ,,pancreatic ,,canc] ,canc] ( ! pancreas c cause sev]e depression & insomnia4 ,^! emotional symptoms c occur e>ly 9 ! c\rse ( ! disease4 ,?is k9d ( canc] kills n9e out ( t5 ( its victims )9 a ye> ( be+ diagnos$4 ,"o reason = ?is trag$y is t pancreatic canc] frequ5tly rea*es an advanc$ /age be=e ! appe>ance ( its physical symptoms3 loss ( appetite & loss ( weight1 nausea1 vomit+1 & upp] abdom9al #ajg pa9 t may spread to ! back4 ,x is believ$ t al]t psy*iatri/s c save _m lives t o!rwise w\ld be lo/ z a result ( pancreatic canc] by detect+ ! disease 9 its e>ly /ages4 ,,anemia ,anemia is caus$ by an abnormal drop 9 ei!r r$ blood cells or hemoglob9 7! ma9 con/itu5t ( r$ blood cells74 ,iron defici5cy c cause anemia1 z c vitam9 ,b#ab or folic acid defici5cy4 ,inh]it$ blood disord]s su* z sickle-cell anemia c also lead to anemia4 ,! ma9 emotional symptom ( anemia is depression4 ,physical symptoms include weakness1 brea?lessness1 & he>t palpitations1 :i* may occur z ! he>t attempts to comp5sate = anemia by circulat+ blood fa/] ?an normal4 ,,he>t ,,conditions ,mitral incompet5ce is a he>t condition 9 :i* ! flaps ( ! mitral valve1 sep>at+ ! upp] & l[] *amb]s ( ! he>t1 d n close prop]ly4 ,! he>t ( a p]son ) ?is disord] mu/ !re=e "w h>d] ?an normal4 ,physical symptoms may involve %ortness ( brea? & fatigue4 ,p>oxysmal ta*yc>dia is ano!r he>t condition1 9 :i* ! he>tbeat sudd5ly spe$s up to #afj beats p] m9ute or m4 ,an attack may la/ = f sev]al m9utes to sev]al days4 ,physical symptoms include brea?lessness1 fa9t+1 *e/ pa91 & aw>5ess ( ! rapid he>tbeats4 ,! emotional symptoms ( bo? mitral incompet5ce & p>oxysmal ta*yc>dia may involve anxiety & panic attacks4 ,,m5opause ,m5opause is n a disord] b a natural condition ( ag+ t involves *anges 9 hormone levels 9 ! body4 ,m5opause 9 wom5 c cause int]mitt5t p]iods ( /rong anxiety1 *ronic n]v\sness1 depression1 irritability1 lack ( confid5ce1 & heada*es4 ,physical symptoms include hot fla%es1 sweat+1 & palpitations4 ,male m5opause is increas+ly be+ recogniz$ by doctors2 symptoms mo/ frequ5tly appe> :5 a man #ajh is 9 8 fifties4 ,emotional symptoms may involve anxiety & depression2 physical symptoms include hot fla%es1 sweat+1 fatigue1 & insomnia4 ,,infecti\s ,,diseases ,frequ5tly1 emotional symptoms are ! fir/ w>n+s ( infecti\s disease4 ,= example1 fatigue & n]v\sness maybe ! only e>ly compla9ts ( pati5ts :o h hepatitis1 infecti\s mononucleosis1 tub]culosis1 & _m o!r diseases4 ,anxiety & tir$ness are symptoms t des]ve c>eful diagno/ic judgm5t2 !y are n always innocu\s4 ,,reactions ,,to ,,m$ication ,bo? ov]-!-c\nt] & prescription m$ications c sometimes produce emotional or m5tal side effects4 ,too1 z ! numb] ( manufactur$ drugs increases1 ! pot5tial = int]actions among diff]5t m$ications increases greatly4 ,c]ta9 drug int]actions produce symptoms ( m>k$ agitation1 re/lessness1 & anxiety4 ,fur!rmore1 pati5ts :o h regul>ly tak5 a p>ticul> m$ication may sometimes f9d t x beg9s to cause unexpect$ side effects4 ,false s5ility 9 eld]ly pati5ts1 = example1 is (t5 induc$ by m$ication2 :5 ! m$ication is /opp$1 ! undesirable symptoms disappe>4 ,,drug ,,addiction ,,& ,,alcoholism ,bo? are runaway habits t c cause n]v\sness & ov]reactions to small crises4 ,ironically1 individuals are usually fir/ attract$ to n>cotics or alcohol 9 ord] to obta9 relief f anxiety4 ,b once ! addictions h become firmly e/abli%$1 emotional symptoms ( depression1 irritability1 sudd5 *anges ( mood1 n]v\sness1 & p>anoia are common1 z are memory loss & difficulty 9 conc5trat+4 ,caffe9e is an emotionally habit-=m+ drug4 ,real addiction--i4e41 physical dep5d5ce ) )drawal symptoms--appe>s to be r>e4 ,nev]!less1 c(fee1 tea1 & cola dr9k]s c become emotionally dep5d5t on caffe9e4 ,! drug is a #aji frequ5t cause ( *ronic n]v\sness 9 habitual caffe9e us]s4 ,smok+ is a habit t causes a p]son to lose approximately #e m9utes ( life expectancy = ea* cig>ette smok$4 ,beyond ?is1 smok+ is also a common b unrecogniz$ cause ( *ronic n]v\sness1 9 spite ( ! fact t _m smok]s believe smok+ w help /eady _! n]ves4 ,by n[ x %\ld be evid5t t ! two ma9 signs ( emotional di/ress--anxiety & depression--c sometimes be ! symptoms ( undetect$ physical disord]s4 ,especially 9 cases ( sev]e anxiety or depression )\t physical compla9ts1 bo? !rapi/s & cli5ts t5d to ov]look ! possibility ( physical illness4 ,x is true t1 at pres5t1 ! majority ( su* cases _c be trac$ to und]ly+ physical causes2 !y are !re=e treat$ by means ( psy*o!rapy or psy*iatric drug !rapy4 ,z m$ic9e & bio*emi/ry develop1 h[ev]1 m5tal & emotional compla9ts are increas+ly be+ und]/ood 9 m physical t]ms4 ,emotional di/ress cle>ly does sometimes mask or cam\flage ! pres5ce ( physical disord]s4 ,if y are suff]+ f s]i\s anxiety or depression1 x is important to h a compreh5sive physical be=e beg9n+ psy*iatric treatm5t4 ,?is is true especially :5 ! onset ( emotional symptoms 0 sudd5--)9 a p]iod ( days or "o to two weeks4 ,x may be mo/ useful to see a diagno/ic speciali/--= example1 a doctor ( int]nal m$ic9e4 ,b be> 9 m9d t physicians1 ev5 ^? :o are famili> ) psy*iatric problems1 v>y consid]ably 9 _! diagno/ic skills1 & sometimes a second op9ion c be wor?:ile be=e y decide t ! mo/ appropriate treatm5t is psy*o!rapy4 #aaa ,,"p ,,ii ,,exp]i5c+ ,,!rapy ,9 ,"p ,,ii y w be able to develop an ov]all und]/&+ ( ! ma9 approa*es to !rapy available today4 ,we w look at psy*oanalysis1 ! fir/ ( ! psy*o!rapies1 develop$ by ,freud at ! beg9n+ ( ! tw5tie? c5tury2 & !n1 9 ! next two *apt]s1 discuss t5 major psy*o!rapies4 ,because ( _! widespread use & value1 individual *apt]s w !n focus on approa*es to behavioral psy*o!rapy1 gr\p !rapy1 & m>riage & family c\nsel+4 ,! two f9al *apt]s 9 ?is section deal ) ! !rapeutic value ( ex]cise1 bi(e$back1 relaxation me?ods1 hypnosis1 m$itation1 psy*oph>macology or ! use ( drugs 9 !rapy1 & diet>y approa*es4 ,9 ! discussion ( ea* approa* to !rapy y w f9d3 99 a concise description ( its special p]spective 99 in=mation on ! k9ds ( problems x is ?\ght to be mo/ useful 9 treat+--& closely connect$ ) ?is1 b seldom tak5 into acc\nt-- 99 a description ( ! k9ds ( individuals :o t5d to pr(it mo/ f t approa*2 & 99 an acc\nt ( a successful exp]i5ce 9 !rapy1 recon/ruct$ f ! reports ( cli5ts z !y look back on _! treatm5t #aab ,,h[ ,,to ,,use ,,"p ,,ii ,!re are two ways y may f9d x pr(itable to use ?is section ( ! book4 ,p]haps y may decide to comb9e bo? ( !m4 ,fir/1 y c use ! map 9 ,*apt] #g to def9e y\r goals & to sugge/ specific approa*es to !rapy t1 bas$ on y\r own self-diagnosis1 y might f9d mo/ b5eficial4 ,on ! o!r h&1 y may n feel t mapp+ out y\r problem or goals 9 ! way t ,*apt] #g sugge/s is = y4 ,p]haps y are simply curi\s ab\t ! field & w\ld l to le>n m ab\t x1 or p]haps y are consid]+ c\nsel+ or psy*o!rapy z an opportunity = p]sonal gr[? & d n h p>ticul> difficulties or issues t y want to focus on4 ,= y1 x may be m relevant to read ab\t a wide range ( approa*es & by s do+ ga9 a cle>] und]/&+ ( :at ! alt]natives are1 h[ !y "w1 & :at !y may (f] y4 ,?is w9d[-%opp+ c !n =m ! basis = a m in=m$ decision lat] on if y want to ent] c\nsel+ or psy*o!rapy4 ,,! ,,exp]i5ces ,,( ,,cli5ts ,,9 ,,!rapy ,! reports 9 ?is book t describe ! p]sonal lives & exp]i5ce ( real individuals 9 !rapy h all be5 delib]ately reca/ to mask all traces ( _! id5tities4 ,_! names1 life situations1 ages1 & o!r *>act]i/ics h be5 *ang$4 ,descriptions ( ! exp]i5ces ( cli5ts 9 !rapy h be5 greatly abbreviat$ & sometimes simplifi$4 ,z we h already se51 c\nsel+ & psy*o!rapy la/ v>y+ l5g?s ( "t4 ,ev5 a v %ort p]iod ( !rapy1 ov] a p]iod ( weeks1 w br+ to light mu* m detail ?an x w\ld be useful = u to discuss "h4 ,! p]sonal lives ( ! real p]sons t are portray$ "h are immeasurably m complex & multifacet$ ?an %ort reports c br+ out4 ,sometimes we w use a "t-lapse /rategy1 describ+ ! evolution ( a p]son's !rapy ov] a p]iod ( _m mon?s by skipp+ ov] weeks at a "t4 ,always ! int5t w be to try to convey to y h[ real p ) real problems h come to deal ) _! difficulties m effectively & (t51 9 ! process1 h be5 able to rea* a ri*] und]/&+ ( !mselves & ( o!rs4 #aac #i ,,psy*oanalysis ,= wide-range improvem5ts 9 individuals :o are n sev]ely impair$ & :o are articulate1 reflective1 pati5t1 self-discipl9$1 & able to make a pot5tially long-t]m commitm5t to !rapy4 ,! pa/ hides b is pres5t4444 ,b]n>d ,malamud1 ,a ,new ,life ,psy*oanalysis is ! root f :i* ! l>ge family ( diff]5t !ories ( psy*o!rapy & c\nsel+ has gr[n4 ,sigmund ,freud's fir/ ef=ts to develop psy*oanalysis began 9 ! #ahhjs4 ,he liv$ a long life & 0 active into 8 eighties2 he di$ 9 #aici4 ,freud left beh9d "o ( ! mo/ important contributions to ! field ( m5tal & emotional heal?4 ,x =m$ ! hi/orical basis = ! div]sity ( approa*es t w\ld foll[4 ,ev5 :5 lat] ?9k]s took issue ) ,freud1 _! "w 9 diff]5t ways reli$ on ! f\ndation ( 8 pione]+ "w4 ,_m ( ,freud's ideas h work$ _! way into our ev]yday vocabul>y3 ! unconsci\s1 ! ego1 repression1 ! ,o$ipus #aad complex1 & s =?4 ,8 "w has influ5c$ ! /udy ( an?ropology1 sociology1 hi/ory1 philosophy1 & lit]ature4 ,,freud',s ,,!ory ,dur+ ,freud's e>ly m$ical tra9+1 he w5t to ,p>is to /udy ) a well-kn[n neurologi/1 ,j4 ,m4 ,*>cot4 ,*>cot _h begun to use hypnosis to treat pati5ts ) c]ta9 physical disord]s--p>alysis1 = example--= :i* !re 0 no app>5t physical cause 7s-call$ hy/]ical symptoms74 ,work+ ) ,*>cot1 & lat] ) a physician1 ,joseph ,breu]1 ,freud began to suspect t ^! symptoms 7 motivat$ by e>li] traumatic exp]i5ces t s di/ress$ ! pati5ts t !y 7 =gott5 7repress$74 ,freud's !ory ( emotional & m5tal illness began !n to take %ape ar\nd ?is c5tral idea t neurotic behavior has a purpose3 !re is an und]ly+ motive1 ! motive itself is v upsett+ to ! p]son1 & s x is repress$ f aw>5ess4 ,b x cont9ues to gnaw away bel[ ! level ( consci\s aw>5ess & ev5tually leads to ! di/urbance t br+s ! pati5t to ! po9t at :i* he or %e is 9 ne$ ( pr(essional help4 ,freud believ$ t recov]y w\ld occur if a pati5t c\ld be help$ to ga9 insight into ^! pa9ful ev5ts & feel+s t _h be5 =gott5 or suppress$4 ,9 a mom5t1 we w look at two real examples4 ,freud's !ory has sev]al dim5sions4 ,fir/1 8 !ory (f]s an explanation ( h[ ! m9d op]ates ?r\gh its def5se me*anisms3 z we h not$1 excessively pa9ful feel+s & memories are repress$4 ,second1 8 !ory tries to id5tify ! diff]5t psy*ologically critical /ages *ildr5 g ?r\gh on _! way to adul?ood3 ! oral1 anal1 & g5ital /ages4 ,& ?ird1 8 !ory seeks to di/+ui% ! p>ts ( ! psy*e1 :i* toge!r und]lie an individual's p]sonality3 ! ego 7! rational portion ( ! m9d t deals ) reality71 ! id 7made up ( basic in/9cts t press = gratification71 & ! sup]ego 7=m$ f p>5tal influ5ces t h be5 int]naliz$74 ,,h[ ,,psy*oanalysis ,,is ,,done ,toge!r1 ^! ?ree s-call$ dynamic1 developm5tal1 & #aae intrapsy*ic dim5sions ( ,freud's !ory make up ! g5]al framework ( psy*oanalysis4 ,! c5tral te*nique ( psy*oanalysis is to help ! pati5t become aw>e ( motives t are unconsci\s4 ,psy*oanalysis1 or analysis = %ort1 is basically an attempt to ext5d self-control1 br++ di/urb+ feel+s & behavior "u a p]son's consci\s managem5t4 ,"o ( ! pr9cipal te*niques is free association4 ,! pati5t is made to feel relax$ & com=table--"o reason a c\* is sometimes us$4 ,he is enc\rag$ to talk 9 an un9hibit$ way ab\t 8 conc]ns & feel+s4 ,dur+ ?is process1 ! analy/ usually rema9s deta*$ & re/ra9$ s z n to int]f]e ) ! pati5t's free expression4 ,f "t to "t1 ! analy/ %>es ) ! pati5t c]ta9 ( ! int]pretations he has develop$ on ! basis ( ! pati5t's reports & behavior4 ,! analy/'s objective is to help ! pati5t recov] lo/ & pa9ful memories t are responsible = ! conflicts1 weaknesses1 or inabilities t cause ! pati5t to suff]4 ,?is process c be v h>d on ! pati5t3 he or %e mu/ revisit exp]i5ces t may be v pa9ful4 ,analysis requires p]sev]ance1 endurance1 & c\rage4 ,x is n1 z we w see1 = ev]yone or e problem4 ,"o ( ! mo/ important developm5ts 9 psy*oanalysis has to d ) ! increas+ popul>ity ( psy*oanalytic psy*o!rapy 7also call$ dynamic psy*o!rapy71 mean+ psy*oanalysis t is extremely brief 7#ab to #bj sessions1 = example74 ,consid]ably m pati5ts are n[ treat$ ) psy*oanalytic psy*o!rapy ?an ) traditional1 int5sive psy*oanalysis4 ,,two ,,examples ,,( ,,psy*oanalysis ,o!r ?an ! l5g? & int5sity ( treatm5t1 ! ma9 diff]5ce betwe5 ,freudian psy*oanalysis & brief analysis has to d ) ! am\nt ( emphasis t is plac$ on sexual matt]s4 ,freud believ$ t an infant's relation%ip to 8 environm5t & p>5ts is pr$om9antly s5sual3 a baby seeks oral gratification2 8 att5tion is absorb$ by :at he puts into 8 m\?4 ,lat]1 att5tion is focus$ on excretory processes2 toilet-tra9+ requires ! *ild to ex]cise self-regulation = ! fir/ "t4 ,lat]1 g5ital sexuality becomes ! dom9ant #aaf int]e/4 ,^! sexual phases ( developm5t id5tify ! dom9ant areas ( att5tion t influ5ce ! infant1 ! *ild1 & !n ! adult 9 _! behavior t[>d o!rs4 ,brief psy*oanalysis g5]ally does n affirm ,freud's sexually bas$ 7libido7 !ory ( motivation4 ,! second example t foll[s illu/rates ?is %ift ( emphasis4 ,! fir/ example 0 describ$ by ,freud himself#a2 ! second illu/rates brief psy*oanalysis4 #a ,sigmund ,freud1 ,lecture #ag1 ,g5]al ,introduction to ,psy*oanalysis 7,new ,york3 ,g>d5 ,city ,pub4 ,co41 #aidc74 ,a ,,case ,,f ,,freud ,freud describes ! analysis ( a girl :o has repress$ a /rong desire = sexual int]c\rse ) h] fa!r & has1 z a result1 develop$ a biz>re patt]n ( behavior4 ,unconsci\sly1 ! dread ( actually mak+ love ) him has g5]aliz$ to a dread ( sexual activity ( any k9d4 ,)\t any consci\s int5t on h] "p1 an association is =m$ betwe5 sexual int]c\rse & break+ a vase4 ,%e is n aw>e ( ! unconsci\s symbolic connection %e has e/abli%$ betwe5 ^! acts4 ,simil>ly1 %e beg9s to associate ! bol/] at ! head ( h] b$ ) h] fa!r & id5tifies h] "m ) ! headbo>d4 ,! pressure ( ?is repress$ mat]ial impels h] to g ?r\gh an elaborate ritual ea* night be=e %e c get to sleep4 ,fir/ %e arranges ! sev]al vases 9 h] room s t %e feels !y are well protect$ aga9/ be+ brok5 7!reby gu>d+ aga9/ sexual int]c\rse74 ,!n %e makes sure t ! bol/] does n come into contact ) ! headbo>d 79 ?is way %e ga9s ! sub/itute satisfaction ( keep+ h] "m & fa!r ap>t74 ,z h] analysis proce$s1 & ! analy/ is able--& "h1 tim+ is important--to enc\rage h] to become consci\s ( h] repress$ feel+s & g5]aliz$ dread ( sex1 h] ne$ = ! nightly ritual is gradually elim9at$4 ,x is n difficult to ?9k ( o!r problems1 sometimes ( a h&icapp+ k9d1 t1 because ( _! obsessive or compulsive nature1 int]f]e ) normal liv+4 ,compulsive h&wa%+ is a classical example2 compulsive ov]eat+1 bulimia1 #aag & its opposite1 anorexia n]vosa1 z well z nymphomania1 a ne$ = sexual promiscuity1 are a few o!rs4 ,,an ,,example ,,( ,,brief ,,psy*oanalysis ,dr4 ,ri*>d ,*ase is a psy*iatri/ :o specializes 9 emotional problems ( *ildr54 ,john & ,ra*el ,edmonton h come to see him ab\t _! twelve-ye>-old son1 ,bobby1 _! only *ild4 ,john is an evangelical m9i/] 9 8 e>ly =ties :o travels a great deal1 tak+ 8 family ) him4 ,:5 ,bobby 0 eight ye>s old1 he began to h /range & viol5t nightm>es4 ,he w\ld g to sleep & !n app>5tly awak5 ab\t an h\r lat]1 ask+ = a dr9k ( wat] or express+ a ne$ to g to ! ba?room4 ,a few m9utes lat]1 ,bobby w\ld seem to lose 8 balance & /umble ov] furniture1 sometimes runn+ into walls1 cry+ al\d t he 0 turn+ inside out & 0 dy+4 ,(t5 8 p>5ts w\ld h to re/ra9 him to keep him f hurt+ himself4 ,aft] a few m9utes1 ! nightm>e w\ld end & ,bobby w\ld come out ( x1 a t]rifi$1 confus$ little boy 9 te>s4 ,s f>1 ,john & ,ra*el1 ) _! frequ5t moves1 _h n be5 able to get pr(essional help t _h made a diff]5ce4 ,bobby _h be5 exam9$ by a neurologi/1 & an electro5cephalograph te/ 0 done to det]m9e if "s k9d ( epileptic disord] might be involv$4 ,! te/ 0 negative4 ,!y _h also tak5 ,bobby to a *ild psy*ologi/1 :o said t ,bobby 0 bright1 s5sitive1 & precoci\s1 t ?is k9d ( nightm>e 0 call$ a night t]ror 7pavor nocturnis71 & t ! problem w\ld ev5tually subside4 ,f\r ye>s pass$1 & ! night t]rors did n4 ,! family ( ?ree 0 becom+ battle-sc>r$4 ,bobby hat$ to g to b$ at night1 fe>+ ! inevitable4 ,8 p>5ts1 sometimes pati5t1 sometimes n1 us$ :atev] ways !y c\ld1 ev5 a prescrib$ s$ative = ,bobby1 s he c\ld relax & get to sleep1 to no avail4 ,c\ld ,dr4 ,*ase help8 ,dr4 ,*ase decid$ to meet ) ,bobby by himself4 ,he f\nd t ,bobby 0 v will+ to talk ab\t 8 bad dreams4 ,dr4 ,*ase ask$ him to describe :at happ5$ ea* night4 ,oh1 ,doctor1 ,bobby began1 x's really awful4 ,i "k x's go+ to happ51 b ,i c't d any?+ to /op x4 ,i /ay up z late z #aah ,i c1 & ,i w d any?+ n to g to sleep4 ,b :5 ,i d1 ,i'll k9d ( wake up a little lat]1 & ,i'll see ,"m & ,dad look+ v worri$4 ,at ! same "t1 ,i'll see a box1 ) :ite walls1 gl[+ brightly1 b n 9 ! room :]e ,"m & ,dad are4 ,x's 9 "s space1 ,i guess x's 9 my m9d1 a black space1 ) t :ite-color$ cube j float+ !re4 ,& !n x beg9s to turn inside out4 ,my /oma* feels l x's turn+ inside out1 & x hurts & sc>es me4 ,x feels awful4 ,i really ?9k if ! cube turn$ all ! way inside out1 ,i'd die4 ,b x nev] does2 ,i always wake up fir/4 ,dr4 ,*ase began to meet ) ,bobby ?ree times a week4 ,he gradually ga9$ 8 tru/4 ,at a session dur+ ! ?ird week ( treatm5t1 he ask$ ,bobby if he w\ld play a ^w association game ) him4 ,,dr4 ,,*ase3 ,tell me :at y ?9k ( :5 ,i say1 dog4 ,,bobby3 ,cat4 ,,dr4 ,,*ase3 ,black4 ,,bobby3 ,:ite4 ,,dr4 ,,*ase3 ,*air4 ,,bobby3 ,cu%ion4 ,,dr4 ,,*ase3 ,box4 ,,bobby3 ,h\se4 ,,dr4 ,,*ase3 ,angry ,,bobby3 ,mad4 ,dr4 ,*ase sp5t ab\t fifte5 m9utes writ+ d[n "s ( ,bobby's associations4 ,bobby gave back associations 9 ! rapid-fire way ,dr4 ,*ase ask$1 do+ ?is almo/ automatically1 leav+ no "t to delib]ate4 ,gradually1 ,dr4 ,*ase felt he saw a patt]n em]g+1 & he 0 able to confirm ?is f ,bobby's associations 9 lat] sessions4 ,t[>d ! end ( ! six? week1 ,dr4 ,*ase sket*$ = ,bobby's p>5ts ! int]pretation he _h develop$ dur+ ,bobby's %ort-t]m exp]i5ce 9 psy*oanalysis3 ,i believe ,bobby has unconsci\sly be5 try+ to tell y some?+ 9 a highly symbolic =m3 (t5 ! m9d expresses deep-seat$ fe>s 9 ! imag]y ( dreams4 ,i've te/$ ,bobby 9 a v>iety ( ways4 ,always1 he appe>s to associate ! box 9 8 dream ) home or ) a h\se4 ,i'm fairly c]ta9 t 'be+ turn$ inside out' symbolizes = him ! process ( mov+ out ( all ! h\ses y h mov$ away #aai f4 ,a h\se really is turn$ inside out :5 y move3 all ( its cont5ts are tak5 out1 usually 9 boxes4 ,i believe ,bobby is hurt+ because ( y\r frequ5t moves4 ,i ?9k if y w /ay 9 "o place1 ev5 ?\gh ,i realize t y1 ,john1 w\ld probably h to give up evangelical "w1 y w gradually see a real improvem5t 9 ,bobby4 ,dr4 ,*ase's advice 0 receiv$ ) a good deal ( disbelief by ,john & ,ra*el1 b !y did1 ev5tually1 decide to try x4 ,john became assi/ant m9i/] at a local *ur*4 ,two ye>s lat]1 ,dr4 ,*ase receiv$ ! foll[+ lett]3 ,de> ,dr4 ,*ase3 ,maybe y'll rememb] treat+ our son1 ,bobby1 = :at y call$ 8 recurr5t night t]rors4 ,my wife & ,i foll[$ y\r advice3 ,we told him we _h decid$ to /ay 9 ,atlanta1 s t he c\ld g to ! same high s*ool = all f\r ye>s4 ,9 ab\t two mon?s1 ,bobby's night t]rors 7 d[n to ab\t "o a week4 ,aft] ?ree mon?s _h pass$1 ! suff]+ our family has endur$ = m ?an five ye>s came to an end4 ,bobby hasn't _h ano!r episode s9ce !n4 ,he's do+ well 9 s*ool1 has fri5ds1 & seems q happy4 ,we all are4 ,x's sure a pleasure to be fre$ f ! exp]i5ce t t]roriz$ u all4 ,bless y1 ,john & ,ra*el ,edmonton ,,an ,,analy/ ,,looks ,,back ,,at ,,8 ,,own ,,psy*oanalysis ,psy*oanalysis is unique among approa*es to c\nsel+ & psy*o!rapy 9 t x requires analy/s1 z a "p ( _! tra9+ lead+ to c]tification1 to und]go psy*oanalysis !mselves4 ,n only is ?is int5d$ to be an educational exp]i5ce1 b x is consid]$ ess5tial to _! compet5ce 9 lat] pr(essional practice3 x is important t !y be completely aw>e ( :at are call$ c\nt]transf]5ce feel+s t[>d pati5ts4 ,j z pati5ts develop t[>d _! !rapi/s feel+s !y _h t[>d significant p]sons 9 ! pa/--call$ transf]5ce--! analy/s1 no less human1 d ! same4 ,_! relation%ips ) _! pati5ts c revive "s ( ! analy/s' own conflicts4 ,!y w be unable to und]/& ! pati5t cle>ly1 free f di/ortions creat$ by _! own #abj c\nt]transf]5ce t5d5cies1 unless !y h come to und]/& !mselves z ?or\ghly z x is possible to d s by means ( _! own psy*oanalysis4 ,aft] und]go+ a long & int5sive p]iod ( p]sonal analysis :ile 9 psy*oanalytic tra9+1 ,dr4 ,tilmann ,mos] ref]r$ to 8 analysis z a successful life-sav+ op]ation = my s\l4 ,he s\ght relief f depression1 caus$1 he n[ believes1 by a tr\bl$ relation%ip ) 8 p>5ts4 ,he describes 8 exp]i5ce 9 ^! t]ms3 ,psy*oanalysis is a piece ( ! "w ( conciliation ) "o's own orig9s4 ,! important ability to be implacable1 atta*$ to ! wrong place 9 ! neurotic un=giv+ness t[>d 444 my p>5ts1 has be5 fre$ = aspects ( life :]e x c be us$ = ef=ts direct$ t[>d social *ange1 ! *ang+ ( conditions t cause avoidable suff]+ to c\ntless human be+s4 ,! longtime impassable road ( affection t[>d my p>5ts1 bas$ on humor1 has be5 re-op5$4#b #b ,tilmann ,mos]1 ,ye>s ( ,appr5tice%ip on ! ,c\*3 ,fragm5ts ( ,my ,psy*oanalysis1 trans4 by ,anselm ,hollo 7,new ,york3 ,uriz5 ,books1 #aigg71 p4 #ah4 ,,applications ,,( ,,psy*oanalysis ,9 g5]al1 psy*oanalysis is successful 9 br++ ab\t :at are call$ broad-spectrum improvem5ts4 ,x is less int5d$ = abatem5t ( specific symptoms4 ,9 o!r words1 ^? ) highly specific goals !y wi% to a*ieve ?r\gh !rapy t5d n to be good c&idates = analysis4 ,= example1 a p]son seek+ specific & prompt relief f depression1 public-speak+ anxiety1 or %yness may n be appropriate = psy*oanalysis4 ,long-t]m1 int5sive psy*oanalysis1 because x is long-la/+ & v detail$1 c lead to v broad improvem5ts3 a s5se ( increas$ satisfaction 9 daily liv+2 a /rong]1 m positive s5se ( self-e/eem2 a great] capacity to enjoy & be at ease ) o!rs4 ,9 ! process1 specific symptoms (t5 d subside or disappe>1 b ! focus is g5]al1 & ! pati5t mu/ be will+ to embrace a commitm5t to g5]al improvem5t4 ,on ! o!r h&1 brief psy*oanalysis may beg9 by focus+ on specific problems exp]i5c$ by a pati5t1 b treatm5t quickly wid5s 9 scope to t\* on matt]s t affect ! #aba pati5t's life 9 a g5]al way4 ,we saw ?is 9 ,bobby's case1 :]e recurr5t night t]rors reveal$ 8 g5]al ne$ = ! great] emotional /ability t comes f feel+ settl$1 hav+ fri5ds1 etc4 ,psy*oanalysis is be/ suit$ to problems t fall into two categories3 99 ,problems t are cle>ly neurotic 9 nature3 !y int]f]e ) liv+ to "s degree b d n totally impair y s t y\r life is cle>ly out ( control1 z 9 cases involv+ psy*oses 7:]e y are no long] able to di/+ui% reality f fantasies & halluc9ations71 alcoholism1 or drug addiction 99 ,problems t involve sexual difficulties1 mood di/urbances1 & impairm5t ( p]sonal relations1 assum+ t y are will+ to "w on ^! problems )9 ! wid] focus t analysis usually requires ,psy*oanalysis is n g5]ally consid]$ to be ! treatm5t ( *oice = sev]e impairm5ts1 su* z alcoholism1 drug abuse1 & psy*otic di/urbances1 :5 y\r life is cle>ly out ( control4 ,analysis is also n g5]ally an appropriate =m ( treatm5t = imm$iate problems aris+ f sudd5 environm5tal *anges1 su* z ! loss ( a job1 or lonel9ess aft] a transf] to a new job location1 or aft] a divorce or sep>ation4 ,9 "s in/ances1 if problems ( ?is k9d are n resolv$ aft] a reasonable adju/m5t p]iod1 analysis might !n be consid]$4 ,o!r approa*es to !rapy l5d !mselves bett] to specific & imm$iate adju/m5t problems1 z we w see4 ,we h be5 describ+ ! appropriat5ess ( psy*oanalysis = ! treatm5t ( c]ta9 k9ds ( problems1 b !re is an equally important1 & frequ5tly ov]look$1 "q3 :e!r psy*oanalysis is appropriate = ! k9d ( p]son y are4 ,psy*oanalysis is be/ suit$ to individuals ) ^! *>act]i/ics3 99 ,!y are v]bally articulate4 99 ,!y h a s5se ( curiosity ab\t !mselves4 99 ,!y h a good reflective capacity & an int]e/ 9 a*iev+ insight ?r\gh a c>eful analysis ( _! ?\ghts1 feel+s1 behavior1 & pa/ hi/ory4 #abb 99 ,!y are comp>atively unimpair$ 9 _! abilities to =m relation%ips4 99 ,!y are able to tol]ate ! fru/ration1 & endure ! pa91 ( re-exp]i5c+ di/urb+ feel+s & memories4 99 ,!y are will+ to be pati5t ?r\gh a pot5tially long p]iod 9 treatm5t & c su/a9 a commitm5t to t process4 #abc #aj ,,psy*o!rapy1 ,,"p ,i ,cli5t-,c5t]$ ,!rapy1 ,ge/alt ,!rapy1 ,transactional ,analysis1 ,rational-,emotive ,!rapy1 & ,exi/5tial-,humani/ic ,!rapy ,! approa*es to !rapy we w look at 9 ?is *apt] are call$ humani/ic !rapies4 ,!y include cli5t-c5t]$ !rapy1 ,ge/alt !rapy1 transactional analysis 7or ,,ta71 cognitive !rapy1 & exi/5tial 7or exi/5tial-humani/ic7 psy*o!rapy4 ,^! approa*es %>e ! view t an effective !rapi/ mu/ be able to become consci\s ( ! _w z x is = ! cli5t4 ,do+ ?is requires ! !rapi/ to h a height5$ s5sitivity to o!rs1 feel a fundam5tal measure ( respect = !m1 & ideally be able to adju/ to _! v individual ne$s & conc]ns4 ,all ( ! !rapies we w exam9e 9 ?is *apt] place priority on ! cli5t's subjective feel+s & exp]i5ces4 #abd ,,cli5t-,,c5t]$ ,,!rapy ,= p :o h n develop$ a s5se ( p]sonal wor?2 :o are 9 ne$ ( acceptance1 human w>m?1 & g5tle enc\ragem5t2 & :o h ! initiative to proce$ bo? 9 !rapy & outside ( !rapy )\t explicit direction f ! !rapi/4 ,! developm5t ( cli5t-c5t]$1 or nondirective1 !rapy has l>gely be5 ! "w ( ,c>l ,rog]s 7#aijb-aihg74 ,8 cl9ical exp]i5ce z a *ild psy*ologi/ & 8 lat] "w 9 tra9+ /ud5ts 9 !rapy l$ him to believe t p frequ5tly come to h p]sonal problems z a result ( ! conditional love ( _! p>5ts4 ,to receive love & approval f _! p>5ts1 *ildr5 mu/ satisfy c]ta9 conditions ( wor? ! p>5ts lay d[n4 ,if ! *ildr5 d n live up to ! p>5ts' dem&s1 !y are puni%$ by ! )drawal ( ! p>5ts' affection--a f> m s]i\s & emotionally sc>r+ puni%m5t ?an a physical spank+4 ,rais$ 9 ?is way1 p lat] 9 life w t5d to l9k _! self-wor? to int]naliz$ p>5tal /&>ds4 ,rog]s obs]v$ t ! m ! love express$ by p>5ts is conditional 9 ?is s5se1 ! m x is likely t a p]son w exp]i5ce emotional difficulties lat] on4 ,z a result1 ,rog]s gradually develop$ an approa* to !rapy t emphasizes unconditional positive reg>d4 ,ideally1 a cli5t-c5t]$ !rapi/ is able to express a s5se ( complete acceptance & respect t[>d ! cli5t4 ,! !rapi/ does n associate positive reg>d ) implicit conditions ( wor? t ! cli5t mu/ satisfy4 ,9 o!r words1 cli5t-c5t]$ !rapy attempts gradually to rev]se a habit t has come to und]m9e ! cli5t's s5se ( self-wor?4 ,x is a habit t we all1 to diff]+ degrees1 develop z p>5ts & society tea* u to rel9qui% self-acceptance 9 favor ( ! conditional love or appreciation ( o!rs4 ,ev5tually1 ! habit becomes s +ra9$ t x c jeop>dize our own feel+s ( self-e/eem4 ,cli5t-c5t]$ !rapy enc\rages a cli5t to gr[ 9 sev]al ways3 #abe #a4 by feel+ com=table en\gh 9 ! company ( ! !rapi/ to express feel+s freely & op5ly #b4 by com+ to recognize 8 own feel+s ( incongru5ce1 ( be+ divid$ aga9/ himself1 (t5 due to exp]i5ces t h enc\rag$ a negative or insecure s5se ( self-wor? #c4 by p]ceiv+ t ! !rapi/ is an integrat$1 accept+ p]son1 able to convey acceptance & w>m? t[>d ! cli5t #d4 by re9tegrat+ a s5se ( self1 free+ himself f ! di/ortions ( self-wor? br\ght ab\t by love t has /r+s atta*$ ,,an ,,example ,melissa ,adams is tw5ty-eight ye>s old1 ! di/rict manag] ( a l>ge ph>maceuticals m>ket+ division 9 ! ,midwe/4 ,%e is sl5d]1 immaculately dress$1 &--z ,dr4 ,feldman c\ld see imm$iately--rigid & v uptight ab\t h]self4 ,melissa came to see ,dr4 ,feldman1 a cl9ical psy*ologi/1 because ( a gr[+ s5se ( e/rangem5t t[>d h] husb& & t5sion & anxiety at "w4 ,%e describ$ h] upbr++ 9 an extremely rigid1 judgm5tal atmosph]e 9 :i* h] self-wor? 0 implicitly ti$ to h] p>5ts' conditions ( a*ievem5t4 ,%e 0 app>5tly enc\rag$ by h] p>5ts1 :o realiz$ ,melissa 0 a bright *ild1 to skip a grade & !n to complete h] und]graduate "w 9 ?ree ye>s by att5d+ summ] s*ool ea* summ]4 ,h] p>5ts 7 v pr\d ( h]4 ,%e admitt$ to hav+ _h little fun & w\ld turn a vacation into an opportunity = a*ievem5t4 ,%e frequ5tly c\ld n enjoy television or ! movies because x felt frivol\s4 ,%e 0 free f self-d\bts only :5 h>d at "w1 s %e work$ virtually all ! "t4 ,h] husb& want$ a family1 b ,melissa believ$ t *ildr5 w\ld be an undesirable int]ruption & di/raction4 ,melissa quickly lo/ h] fe> ( ! weekly meet+s ) ,dr4 ,feldman4 ,%e 0 able to relax 9 8 company4 ,%e felt t he c>$ ab\t h] z a p]son1 :e!r %e a*iev$ or did n4 ,he w\ld n make active1 directive sugge/ions1 b r li/5$ #abf to h] 9 a g5u9e1 positive way4 ,dur+ "o session1 ,melissa ask$ him if he w\ld give h] "s /raight advice ab\t h] relation%ip ) h] husb&4 ,dr4 ,feldman decl9$4 ,he felt t tell+ ano!r p]son :at to d did n %[ respect = t p]son's individuality4 ,he c\ld see t ,melissa 0 intellig5t4 ,he believ$ t %e c\ld tru/ h] own decision-mak+ abilities1 & he w\ld enc\rage h] to believe 9 h]self4 ,ov] a p]iod ( a little m ?an a ye>1 ) weekly visits1 ,melissa's p]sonality began to s(t54 ,%e dress$ m casually4 ,%e 0 m relax$4 ,%e 0 beg9n+ to enjoy h]self m1 al?\gh occasionally ! old self-d\bts w\ld come back to assail h]4 ,b %e usually 0 able to f5d !m (f4 ,h] m>riage 0 improv+1 %e look$ =w>d to a real vacation 9 ! ne> future1 & %e 0 n clos$ to discuss+ ! possibility ( *ildr5 ) h] husb&1 al?\gh !y _h n yet made a decision on t issue4 ,,applications ,,( ,,cli5t-,,c5t]$ ,,!rapy ,cli5t-c5t]$ !rapy focuses especially on difficulties t /em f a cli5t's negative feel+s ( self-wor?4 ,cli5t-c5t]$ !rapy may be ! !rapy ( *oice especially = individuals :o feel anxiety1 unc]ta9ty1 & pa9 because ( a l[ s5se ( self-e/eem4 ,a cli5t-c5t]$ !rapi/ c be expect$ to value p]sonal g5u95ess1 integrity1 & hone/y4 ,! approa* c be helpful to p]sons :o suff] f lonel9ess & isolation4 ,cli5t-c5t]$ !rapy is mo/ effective = individuals ) ^! *>act]i/ics3 99 ,!y are able to ex]cise initiative1 bo? 9 express+ _! difficulties to ! !rapi/ & 9 attempt+ to make desir$ *anges4 ,mo/ cli5t-c5t]$ !rapi/s w refra9 f giv+ direction4 99 ,!y are int]e/$ prim>ily 9 p]sonal gr[? r ?an ! removal ( specific symptoms4 99 ,!y are block$1 inhibit$1 or rigid because !y are too self-critical4 99 ,!y are n sev]ely impair$ 9 _! abilities to relate to o!rs4 #abg ,,ge/alt ,,!rapy ,= v rigid p :o are always try+ to be someone !y are n1 :o w commit !mselves to a *all5g+ & usually fru/rat+ process ( gr[? lead+ to p]sonal integration & g5u95ess4 ,,ge/alt ,,psy*ology ,ge/alt !rapy has its roots 9 ,ge/alt psy*ology1 :i* 0 e/abli%$ e>ly 9 ?is c5tury by ! ,g]man psy*ologi/s ,wolfgang ,khl] 7#ahhg-aifg71 ,kurt ,k(fka 7#ahhf-aida71 & ,max ,w]!im] 7#ahhj-aidc74 ,! ma9 contribution ( ,ge/alt psy*ology consi/$ ( /udies ( human p]ception4 ,ge/alt psy*ologi/s demon/rat$ t p]ception reveals ! exi/5ce ( organiz$ :oles t _c be r$uc$ to ! sum ( _! p>ts4 ,!y call$ su* an organiz$ totality a ,ge/alt4 7,outside ( psy*ology1 ,ge/alt 9 ,g]man means =m47 ,a fam\s example1 %[n bel[1 demon/rates h[ an object t y see c be closely l9k$ to its backgr\nd4 ,"h1 ! figure & ! gr\nd c oscillate1 dep5d+ on :e!r y conc5trate on ! faces or ! vase4 ,! figure dep5ds on its backgr\nd = its id5tity1 & vice v]sa4 ,illu/ration3 ,a fam\s illu/ration ( a :ite vase set betwe5 ! black silh\ettes ( two faces 9 pr(ile2 at "o mom5t y p]ceive ! vase1 at ano!r y see ! two faces #abh ,,ge/alt ,,!rapy ,fr$]ick 7,fritz7 ,p]ls 7#ahic-aigj7 br\ght toge!r c]ta9 ( ! basic concepts ( ,ge/alt psy*ology1 psy*oanalysis1 & psy*odrama1 an approa* to !rapy develop$ by ,j4 ,l4 ,mor5o 7#ahhi-aigd7 t emphasizes role-play+1 act+ out ( fantasies1 & gr\p int]action4 ,p]ls trans=m$ ! ,ge/alt psy*ologi/s' c5tral idea s x w\ld s]ve z a basis = 8 approa* to psy*o!rapy4 ,let's look at an example4 ,a man has be5 /r&$ 9 ! des]t & has become sev]ely dehydrat$4 ,he has w&]$ = sev]al days 9 se>* ( wat]4 ,he /umbles along1 ne>ly bl9d$ by ! sun1 see+ only vaguely def9$ %apes ( rocks & cacti4 ,sudd5ly1 out ( ?is hazy _w1 some?+ becomes cle>ly def9$3 he sees a wat]+ hole1 surr\nd$ by l[ bu%es4 ,x is cle>ly et*$ 9 8 eyes1 set aga9/ ! indi/9ct backgr\nd ( ! hot des]t4 ,once he has plung$ 8 head into ! wat] & qu5*$ 8 ?ir/1 8 ,ge/alt is clos$3 ! ne$ t caus$ him to /ruggle = days has p]=m$ its purpose4 ,9 ?is d]ivative s5se1 ,ge/alt means a problem 7figure7 t arises out ( a situation 7backgr\nd7 :i* motivates an individual to action4 ,if 8 action is successful1 8 ,ge/alt is clos$3 ! problem is resolv$1 & ! motivation is fulfill$4 ,l ! ,ge/alt ( ! psy*ologi/s1 ! clos$ ,ge/alt ( !rapy signifies an organiz$ :ole4 ,9 ! example1 ! man suff]+ f ?ir/ 9 ! des]t has a ,ge/alt t impels him to f9d wat]4 ,:5 he does1 8 ?ir/ is satisfi$1 & ! ,ge/alt is resolv$ into a :ole t no long] /&s 9 ne$ ( completion4 ,p]ls saw life z a succession ( unf9i%$ situations1 incomplete ,ge/alts4 ,no soon] is "o clos$ ?an ano!r takes its place4 ,to cope effectively ) liv+1 we mu/ be able to deal ) life's problems & *all5ges1 yet n all ( u c4 ,p]ls us$ ! t]m gr[? disord]s to ref] to :at o!r !rapi/s might call p]sonality disord]s or neuroses4 ,he believ$ t emotional problems result f gett+ /uck 9 ! natural process ( gr[?4 ,p get /uck 9 *ildi% patt]ns ( dep5d5cy because ( a v>iety ( *ildhood exp]i5ces4 ,= example1 a "m & fa!r may )draw ! support ( a /able environm5t1 :ile a *ild relies on ?is = a s5se ( security4 7,! example ( ,bobby 9 ! *apt] on #abi psy*oanalysis may come to m9d47 ,or1 p>5ts may =ce a *ild to accept adult responsibilities prematurely4 ,x is z if a *ild 7 ask$ to walk be=e 8 s5se ( balance & leg /r5g? _h develop$ suffici5tly4 ,! *ild w le>n unc]ta9ty2 8 natural e>ly fe> ( fall+ becomes pron\nc$ & w leave a m>k t c /& 9 8 way lat]4 ,p]ls call$ su* exp]i5ces impasses1 & !y =m blocks to a p]son's gr[?4 ,= ,p]ls1 human p]sonality is l a multilay]$ onion3 ,f ! mo/ sup]ficial1 outside lay]1 mov+ inw>d1 !re is ! usually ins9c]e cli* lay] 7,h[ are y81 ask$ )\t real int]e/71 ! role-play+ lay] 7! habitual masks ( fa!r1 "m1 bus9essp]son1 homemak]1 !rapi/1 cli5t71 ! impasse lay] 7! p]son /ripp$ ( cli*s & masks1 (t5 v fright5+71 ! implosive lay] 7:]e emotions are ei!r v5t$ or explode inw>d71 & ! inn]mo/ lay]1 :i* makes up ! g5u9e p]sonality z x is1 fre$ f le>n$ pret5sions4 ,! goal ( ,ge/alt !rapy is to rea* ?is la/ lay]4 ,9 a ^w1 ,ge/alt !rapy seeks to enc\rage ! gr[? ( au!nticity--a comb9ation ( a balanc$ s5se ( reality1 ( inn] integration complem5t$ by its outw>d expression1 p]sonal integrity1 & ( indep5d5ce f ! ne$ = ! approval ( o!rs4 ,9 ,ge/alt !rapy1 self-*ange seems p>adoxical4 ,z long z inn] conflicts cont9ue1 y try n to be ! p]son y are2 y _c be g5u9e & are divid$ aga9/ y\rself4 ,*ange1 ! ,ge/alt !rapi/ claims1 is possible only :5 y give up1 at lea/ = a "t1 try+ n to be ! p]son y are4 ,!re mu/ be a firm place to /& f :i* to initiate *ange1 & t place c only be ! p]son y are "r n[4 ,,:at ,,ge/alt ,,!rapy ,,is ,,l ,ge/alt !rapy z x 0 develop$ by ,p]ls is individual !rapy done 9 a gr\p sett+4 ,ge/alt !rapi/s s9ce ,p]ls mo/ commonly cont9ue to practice !rapy ?is way3 individual memb]s ( a gr\p are ask$ to volunte] to take ! hot seat2 ! volunte] !n becomes ! focus ( att5tion4 ,?is is n gr\p !rapy :]e relation%ips among memb]s ( ! gr\p are mo/ important 7see ,*apt] #ac74 ,9 ,ge/alt !rapy1 emphasis is on ! individual1 :o is pu%$ to drop 8 or h] masks & pret5sions4 ,o!r memb]s ( ! gr\p =m an #acj audi5ce & try to le>n by example until x is "t to occupy ! hot seat !mselves4 ,p]ls w\ld ask = someone 9 ! gr\p to sit 9 a *air1 fac+ him & ! audi5ce4 ,!n ,p]ls w\ld laun* an attack on ! cli5t's def5ses4 ,at times1 he c\ld be almo/ m]ciless4 ,he did n believe 9 mo!r+ cli5ts2 ?is s]v$ only to keep _! def5ses intact4 ,p]ls w\ld notice nonv]bal clues to ! cli5t's feel+s4 ,if ! cli5t 0 an inhibit$ woman1 he w\ld comm5t ab\t h] ?ighs1 :i* 7 press$ firmly toge!r4 ,if ! cli5t 0 %y1 he w\ld rem>k ab\t h[ ! cli5t held "o h& 9 ! o!r3 ,did he feel a ne$ to h 8 h& held by ,"m8 ,if ! cli5t bur/ into te>s1 ,p]ls w\ld make no attempt to /op ! te>s ) reassurance b w\ld try to make ! cli5t aw>e ( 8 motivation 9 cry+3 ,0 x to elicit pity8 ,7 ! te>s a way ( hid+ f self-responsibility8 ,7 ! te>s ano!r mask1 /&+ 9 ! way ( self-acceptance1 au!nticity1 & gr[?8 ,! objective ( ,ge/alt !rapi/s is to te> away cli5ts' def5sive masks & roles t usually keep !m f real1 sometimes pa9ful or fright5+1 feel+s4 ,9 ?is1 ! !rapi/s' ma9 te*nique is to fru/rate ! cli5ts' attempts to hide beh9d _! masks & roles & to block _! attempts to control _! !rapi/4 ,cli5ts (t5 d ?is by try+ to make ! !rapi/ feel sorry = !m1 give !m p>5tal w>m?1 respond to _! inadequacies1 & s on4 ,in/ead1 ,ge/alt !rapy is comp>atively t\gh4 ,p]ls us$ ^! in/ructions 9 beg9n+ a work%op3 ,s if y want to g crazy1 commit suicide1 improve1 get turn$-on1 or get an exp]i5ce t w *ange y\r life1 x's up to y4 ,i d my ?+ & y d y\r ?+4 ,anybody :o does n want to take responsibility = ?is1 please d n att5d ?is session4 ,y come "h out ( y\r own free w4 ,i don't "k h[ gr[n up y are1 b ! ess5ce ( a gr[n-up p]son is to be able to take responsibility = himself--8 ?\ghts1 feel+s1 & s on4 ,any objections8 444 ,o4,k4#a #a ,fr$]ick ,p]ls1 ,ge/alt ,!rapy ,v]batim 7,lafayette ,,ca3 ,real ,p ,press1 #aifi71 p4 #gi4 #aca ,by refus+ to give unnecess>y emotional support ev5 :5 cli5ts cry = x1 ,ge/alt !rapi/s convey ?r\gh _! behavior t cli5ts d h :at x takes to /& on _! own two feet4 ,ideally1 ,ge/alt !rapi/s are g5u9e1 mature p2 !y refra9 f int]f]+ 9 ! lives ( o!rs & expect !m to be self-support+4 ,!y try to impress on _! cli5ts t !y d n exi/ to live up to ! expectations ( o!rs1 nor d o!rs exi/ to live up to !irs4 ,,applications ,,( ,,ge/alt ,,!rapy ,ge/alt !rapy is mo/ effective 9 treat+ p]sons ) ^! *>act]i/ics3 99 ,!y t5d to be v rigid--re/ra9$1 ov]controll$1 p]fectioni/--or depress$1 or phobic4 ,t is1 !y h c]ta9 well-def9$ fe>s2 = example1 fe> ( public speak+1 ( insects1 ( sexual int]c\rse4 99 ,!y h become /ultifi$ 9 _! relations ) o!rs & h p5t-up feel+s 9 ne$ ( release4 99 ,!y obta9 little joy or satisfaction f liv+2 _! lives lack emotional int5sity4 99 ,!y are n excessively fright5$ by gr\p activity4 ,specific conditions ,ge/alt !rapy (t5 treats include ^!3 99 psy*osomatic disord]s1 su* z /oma* pa91 colitis1 back & neck spasms1 & migra9es 99 behavior problems 9 *ildr5 99 difficulties 9 cop+ ) p]sons 9 au?ority 99 %yness & passivity 99 emotional difficulties aris+ f pov]ty & f ! deprivations suff]$ by m9ority gr\ps 99 rigid1 conflict-torn family situations 99 crisis int]v5tion3 treat+ individuals 9 despair :o h lo/ ! w to live or are suicidal ,ge/alt !rapy is n g5]ally ! treatm5t ( *oice = p ^: lives are out ( control or :o %[ signs ( psy*osis4 ,ge/alt !rapy relies on y\r capacity to make y\r #acb own practical life decisions1 to tol]ate ! /ress & fru/ration ( be+ 9 ! hot seat1 & to b5efit f be+ *all5g$ by ! !rapi/ to confront y\r own pret5ses1 di/ortions1 & confusions4 ,p :o h lo/ ^! capacities = ! "t be+ due to problems su* z alcoholism1 drugs1 & loss ( t\* ) reality t5d n to b5efit f ,ge/alt te*niques4 ,,transactional ,,analysis ,= less tr\bl$ p :o want to improve ! effectiv5ess ( _! communication skills & break free f fru/rat+1 self-de/ructive patt]ns4 ,transactional analysis has p]haps done m ?an any ( ! o!r ma9 approa*es to !rapy to increase ! s5sitivity ( ! public to ! psy*ological dim5sions ( human relation%ips4 ,x has a*iev$ widespread popul>ity 9 a %ort "t l>gely because ( its simple1 commons5se vocabul>y t is easy to apply to p]sonal1 family1 & gr\p situations4 ,eric ,b]ne 7#aiaj-aigj7 complet$ 8 m$ical tra9+ 9 #aice1 !n f9i%$ 8 psy*iatric resid5cy at ,yale 9 #aida4 ,he soon sep>at$ himself f psy*oanalysis & began to =mulate 8 !ory ( transactional analysis 7,,ta74 ,by ! mid-sixties1 ,,ta 0 ga9+ 9 popul>ity3 ,b]ne wrote 8 book1 ,games ,p ,play1 prim>ily = pr(essionals1 b x became a be/-sell] fill+ a ne$ = an easy-to-und]/& & easy-to-apply approa* to !rapy4 ,,ta is bas$ on ! premise t human p]sonality has ?ree p>ts3 ,b]ne call$ !m ! ,p>5t1 ,adult1 & ,*ild4 ,al?\gh simil> 9 mean+ to ,freud's sup]ego1 ego1 & id1 ,b]ne's t]ms 7 int5d$ to "n dim5sions ( p]sonality t c\ld be obs]v$ directly2 8 ?ree ego /ates are n !oretical con/ructs4 ,! ,*ild ego /ate is ! s\rce ( fun1 humor1 creativity1 wi%ful ?9k+1 & irresponsibility4 ,x is impulsive & resi/s control4 ,! ,p>5t ego /ate is ! repository ( values1 attitudes1 & expectations inh]it$ f "o's p>5ts4 ,%\lds1 oughts1 #acc h&s-on-hips1 & f+]-wagg+ ge/ures are common expressions ( ! ,p>5t4 ,! ,adult ego /ate is ! s\rce ( reason1 logic1 & unemotional evaluation4 ,x =ms ! basis = decision mak+ & pr$ict+ outcomes4 ,only "o ego /ate c be 9 control ( our emotions or behavior at a "t4 ,b]ne obs]v$ t _m emotional difficulties 9 individual cli5ts result f problems involv+ _! ego /ates4 ,"s p]sonality problems come ab\t because a p]son _c sep>ate 8 or h] ego /ates & swit*es f "o to ano!r erratically & uncontrollably4 ,= example1 a "y "m beg9s--9 a calm rational way--to describe ! behavior ( h] n9e-ye>-old son4 ,%e talks ab\t 8 imp]t95t & disrespectful behavior1 &1 z %e does1 %e becomes enrag$1 h] face turns beet-r$1 & %e yells at h] !rapi/ t som$ay %e is go+ to give h] boy a beat+ he'll nev] =get6 ,transactional analysis w\ld try to %[ h] t %e t5ds to slip f h] reasonable ,adult /ate to ! /ate ( an angry ,p>5t :o dem&s complete respect & subs]vi5ce4 ,b]ne call$ ?is /ructural problem ( ! p]sonality confusion4 ,illu/ration3 ,,p]sonalities3 ,normal ,p]sonality1 ,confus$1 ,exclud$1 ,contam9at$ ,exclusion is ano!r /ructural problem4 ,an individual rigidly adh]es to "o ego /ate1 lock+ out ! o!r two4 ,a ,don ,juan gives free expression to 8 ,*ild1 :ile 8 ,adult & ,p>5t /ates are suppress$4 ,a workaholic1 on ! o!r h&1 p]mits #acd 8 ,p>5t to block ! expression ( 8 ,adult & ,*ild ego /ates4 ,contam9ation is a ?ird p]sonality problem4 ,"o ego /ate subv]ts ano!r4 ,a woman _c commit h]self fully to h] *os5 pr(ession because h] ,*ild has und]m9$ h] s5se ( det]m9ation by p]suad+ h] t a weal?y knight 9 :ite armor w soon appe> to relieve h] ( ! ne$ to ex]t h]self4 ,,:at ,,transactional ,,analysis ,,is ,,l ,transactional analysis normally beg9s ) /ructural analysis 9 :i* cli5ts are taught h[ to di/+ui% ego /ates t may be confus$1 exclud$1 or contam9at$4 ,?is phase ( !rapy is sometimes done on an individual basis & sometimes 9 a gr\p work%op or classroom environm5t4 ,!rapy !n proce$s to transactional analysis prop]1 9 :i* fru/rat+ or pa9ful =ms ( communication & unsatisfy+ life directions are discuss$4 ,mo/ commonly ?is is done 9 a gr\p sett+1 s9ce a gr\p enc\rages a v>iety ( diff]5t /yles ( communication4 ,,ta tea*es cli5ts to det]m9e :i* ego /ate is active at a giv5 mom5t--9 !mselves & 9 o!rs ) :om !y are try+ to communicate4 ,transactions or communication patt]ns betwe5 p are ! focus ( ,,ta4 ,"s typical transactions are diagramm$ on ! fac+ page4 ,9 7a7 on ! fac+ page1 p]son #a communicates 9 an ,adult mode & receives an ,adult response f p]son #b3 ,:]e are y go+8 ,to ! clean]'s4 ,9 7b71 a ,p>5tal boss receives a petulant response f ! ,*ild ego /ate ( an employee3 ,:at took y s long8 ,my little boy is sick1 & !re's j too mu* "w = "o secret>y4 ,9 7c71 an ,adult-to-,adult message receives a ,*ild-to-,p>5t reply2 ?is is an example ( cross$ transaction4 ,x is "o ( ! mo/ common s\rces ( fru/ration & conflict 9 family & pr(essional life4 ,= example1 a !rapi/ says1 ,y seem to be late = y\r appo9tm5t today4 7,adult-to-,adult1 or ,a-,a47 ,! cli5t replies1 ,y're j l my fa!r1 always pick+ on me4 7,c-,p47 #ace ,illu/ration3 ,,diagrams ,,( ,,typical ,,transactions #acf ,diagram 7d7 illu/rates communication t involves an ult]ior message4 ,= example1 a psy*ologically clev] salesman is %[+ hair dri]s to a woman4 ,%e tells him h[ mu* %e is prep>$ to sp5d & !n asks1 ,h[ mu* is t "o8 ,! salesman 7arr[ #a 9 ! diagram7 replies3 ,y w\ldn't be able to af=d t model4 ,8 response is bas$ on 8 cu/om]'s /at$ budget limitations & appe>s to be ,adult-to-,adult4 ,h[ev]1 ! hidd5 message 7dott$ arr[ #a7 is direct$ to 8 cu/om]'s ,*ild /ate1 :i*1 z he pr$icts1 causes h] to reply rebelli\sly 7arr[ #b71 ,t's ! "o ,i want4 ,9 7e71 ano!r example ( ?is class ( communications t are n :at !y appe> to be1 !re are two ult]ior transactions4 ,a secret>y returns a few m9utes late f lun*4 ,h] boss asks1 app>5tly ,adult-to-,adult 7arr[ #a71 ,:at "t is x8 ,!y bo? "k :at ! hidd5 message is4 ,! secret>y answ]s %>ply 7arr[ #b73 ,x's #a3ae4 ,! ult]ior message f ! boss is ,are y late aga98 7,p-,c3 arr[ #a47 ,! secret>y's cov]t or hidd5 reply is ,get (f my back3 y're always criticiz+4 7,c-,p3 arr[ #b47 ,! c5tral objective ( ,,ta1 !n1 is to make cli5ts aw>e ( ^! & o!r patt]ns or games t _! habitual ways ( communicat+ reveal4 ,by do+ ?is1 cli5ts f9d t communication becomes less problematic & m effective z !y le>n to control _! responses4 ,,an ,,example ,joyce 0 =ty-"o :5 %e decid$ to take h] sev5te5-ye>-old only son1 ,joe1 to see ,dr4 ,gold/e91 a transactional analy/4 ,= ab\t five ye>s1 ev] s9ce 8 fa!r di$1 ,joe & 8 "m _h qu>rel$ a great deal4 ,dr4 ,gold/e9 met ) ,joyce1 !n ) h] son1 & !n ) !m bo?4 ,aft] he li/5$ to _! compla9ts ab\t "o ano!r1 he agre$ to try to help4 ,= six weeks1 ,joe & 8 "m met once a week ) ,dr4 ,gold/e9 z ,,ta /ud5ts4 ,!y 7 to put family problems on a back burn]2 _! en]gy 0 devot$ to le>n+ to apply ! concepts ( transactional analysis4 ,dr4 ,gold/e9 _h !m #acg analyze _m examples ( communication4 ,dur+ a second six-week p]iod1 ,joyce & h] son 7 coa*$ to le>n to talk to "o ano!r m effectively4 ,"h are "s samples ( _! automatic patt]ns ( response be=e !y began to use ,,ta3 ,,son3 ,! s\p's too salty4 7,a-,a or ,c-,p7 ,,"m3 ,i don't "k :y ,i "w s h>d6 ,all y d is compla96 ,i'm j n appreciat$6 7,c-,p7 ,,son3 ,mom1 "h's ! sports jacket ,i b\ght = graduation4 7,a-,a7 ,,"m3 ,y c't g 9 t6 ,we're tak+ t jacket back4 ,i c't tru/ y to buy clo!s = y\rself4 ,let's g6 7,p-,c7 ,,"m3 ,we're go+ to d9n] tonight at ,e/h] & ,g>y's4 ,get out ( ^? jeans2 we h to leave 9 fifte5 m9utes4 7,p-,c7 ,,son3 ,b ,mom1 ,i told y la/ ,w$nesday t ,fr$ & ,i are go+ camp+ ?is week5d4 ,we're leav+ 9 ,fr$'s c> 9 j an h\r4 7,a-,a or ,c-,p7 ,,"m3 ,i don't rememb] any?+ l t4 ,e/h] & ,g>y are expect+ u4 ,y're always wreck+ our plans6 7,c-,p7 ,,"m3 ,mmm1 isn't ?is ! mo/ delici\s s\ffl y've ev] ta/$8 7,c-,p7 ,,son3 ,t's x1 complim5t y\rself6 7,c-,p7 ,,"m3 ,well1 if ,i don't1 no "o else w6 ,y don't "k h[ lucky y are1 hav+ a "m :o really kn[s h[ to cook4 7,c-,p7 ,,son3 ,i sure hope ,i don't le>n h[ to be mode/ f y6 7,c-,p7 ,! problems w]5't h>d = ,dr4 ,gold/e9 to spot3 ,joyce _h l[ self-e/eem1 0 easily hurt1 &1 :5 %e 01 put h] son d[n 7! salty s\p74 ,%e want$ to be indisp5sable to him & 0 unwill+ to let him gr[ up 7! sports jacket74 ,%e _h little respect = ,joe's plans1 especially if !y int]f]$ ) h] desires 7,joe's camp+ trip74 ,%e felt unappreciat$ & _h gr[n to be res5tful ( h] role z "m 7! s\ffl74 ,joe1 on ! o!r h&1 0 feel+ ! natural rebelli\sness #ach ( a sev5te5-ye>-old4 ,he ne$$ "s free re91 ev5 if he made "s mi/akes4 ,8 "m 0 always gett+ 9 8 hair or gett+ "u 8 sk94 ,! sample transactions above l$ ea* ( !m to ang] & hurt4 ,seldom did ,dr4 ,gold/e9 see ,joe & 8 "m communicate ,adult-to-,adult4 ,in/ead1 _! transactions cross$ & re-cross$1 & res5tm5ts pil$ up4 ,joyce saw ,dr4 ,gold/e9 )\t ,joe pres5t = sev]al weeks4 ,%e le>n$ f ,dr4 ,gold/e9 t h] expectations t[>d h] son 7 inappropriate2 %e ne$$ to /r5g!n h] s5se ( self-wor? outside ( h] family role4 ,%e 0 excessively dep5d5t on h] son = recognition & appreciation4 ,especially s9ce h] husb& di$1 %e 0 easily hurt :5 h] desires = appreciation 7 n satisfi$ by ,joe1 s %e put him d[n4 ,:at %e ne$$ to d 0 to /r5g!n h] ,adult & weak5 ! dom9ation ( h] self-pity+ ,*ild & ov]critical ,p>5t ego /ates4 ,dr4 ,gold/e9 !n met ) ,joe = sev]al sessions4 ,joe began to see 8 "m 9 a diff]5t light4 ,dr4 ,gold/e9 made him aw>e ( 8 "m's sadness 9 be+ left alone & ( h] ne$s to feel wor?:ile4 ,dur+ ! jo9t sessions t foll[$1 ,dr4 ,gold/e9 typically w\ld ask !m to recall rec5t conv]sations or ex*anges t _h be5 unpleasant4 ,he w\ld ask !m to analyze ^! 9 ,,ta t]ms & !n w\ld pu% "m & son to imag9e m appropriate & less uptight ways ( respond+4 ,aft] sev]al mon?s ( jo9t !rapy1 _! =m] patt]n ( transactions began to look v diff]5t3 ,,son3 ,mom1 !re's too mu* mu/>d on ! ham4 7,a-,a or ,c-,p7 ,,"m3 ,well1 !n x's ,,ok ) me if y want to scrape "s (f4 7,a-,a or ,p-,c7 ,,son3 ,h[ d y l my new tie8 7,a-,a7 ,,"m3 ,i'd ne$ a lot ( c\rage to we> x myself1 b ,i'm n y6 7,a-,a or ,c-,c7 ,,son3 ,mom1 y\r roa/ is delici\s4 ,x's great to h a "m :o's a good cook6 7,a-,a7 ,,"m3 ,?anks1 ,joe4 ,i guess n[ ,i've le>n$ t y really hate s\ffl6 7,a-,a7 #aci ,,applications ,,( ,,transactional ,,analysis ,,ta has be5 us$ 9 individual & gr\p !rapy1 9 noncl9ical sett+s to help bus9ess executives improve communication skills1 & also 9 prisons4 ,x has be5 us$ to treat a wide range ( problems1 includ+ ^!3 99 p]sonality trait problems3 e4g41 %y1 lonely1 depress$1 ov]be>+1 or ho/ile individuals 99 tr\bl$ relation%ips 9 c\ples & families 99 fe>s ( )drawal ( affection & ( ab&onm5t 99 drug abuse 99 phobias 99 difficulties 9 relat+ to au?ority figures1 su* z a boss1 a tea*]1 a p>5t 99 adaptation problems 9 individuals ) c\nt]culture attitudes & values ,few controll$ evaluative /udies h be5 done to det]m9e h[ effective ,,ta really is4 ,at ?is "t1 & 9 ?is au?or's judgm5t1 ,,ta is mo/ useful z an educational !rapy to assi/ less sev]ely tr\bl$ individuals ) communication problems by help+ !m %>p5 _! p]ceptions ( _! own ego /ates & ! ego /ates ( o!rs4 ,,ta is mo/ effective = cli5ts :o are able to ex]cise responsibility = !mselves4 ,,ta appe>s to be especially useful 9 help+ individuals :o are caught 9 fru/rat+ relation%ips to break free f self-de/ructive patt]ns or games4 ,,cognitive ,,!rapy3 ,,rational-,,emotive ,,!rapy ,= p :o t5d to ?9k & judge 9 v rigid ways1 :o are frequ5tly int5se & uptight1 & :o t5d to magnify & exagg]ate evils4 ,man is n di/urb$ by ev5ts1 b by ! view he takes ( !m4 ,epictetus1 ,en*iridion #adj ,x is absolutely ess5tial to y to be lov$ by memb]s ( y\r family & to be appreciat$ by y\r fri5ds & employ]4 ,y mu/ be consi/5tly compet5t & ne>ly p]fect 9 all y\r endeavors4 ,"s p are really bad1 _! actions %\ld be re/rict$1 & !y %\ld be puni%$ :5 !y d wrong4 ,x is t]rible :5 ?+s are n ! way y w\ld l !m to be4 ,ev5ts outside y\r control are l>gely responsible = h[ y feel4 ,y %\ld be anxi\s 9 relation to :at is unc]ta91 unkn[n1 or pot5tially dang]\s4 ,x is mu* easi] to avoid problems ?an to face life's difficulties & responsibilities4 ,x is necess>y to h some?+ great] or /rong] ?an y\rself to rely on4 ,! pres5t is l>gely det]m9$ by pa/ ev5ts4 ,happ9ess comes :5 "o has complete leisure4 ,if y don't "w h>d to please o!rs1 !y w ab&on y4 ,if p don't approve ( y1 y ought to "q y\r self-wor?4 ,by tell+ ourselves ?+s l ^!1 we create our own unhapp9ess1 fru/ration1 & ang]2 t is ! po9t ( view ( cognitive !rapy4 ,dur+ ! #aiejs1 ,alb]t ,ellis 7#aiac-bjjg7 develop$ a !ory ( p]sonality t claims t p are l>gely responsible = _! emotional reactions4 ,!y tell !mselves t ?+s ought to be diff]5t1 t p %\ld d c]ta9 ?+s1 & t :at !y desire !y mu/ h4 ,life1 = p ^: ?\ghts are fill$ ) %\lds1 oughts1 & mu/s1 is full ( disappo9tm5t1 annoyance1 & hurt4 ,ellis obs]v$ t1 z "t goes by1 we t5d to re9=ce an emotional patt]n t amplifies our s5sitivities m & m4 ,! emotional reactions we create 9 ourselves become m exagg]at$1 di/ort$1 & self-de/ructive4 #ada ,b1 l any habits1 ^! m5tal 7or cognitive7 habits c be brok54 ,cognitive !rapy attempts to d ?is4 ,ellis call$ 8 own approa* rational-emotive !rapy4 ,by ?is1 he ackn[l$g$ t p h bo? rational & emotional dim5sions4 ,_! emotions & ?\ghts 7cognitions7 are s ?or\ghly int]tw9$ t !y _c be cle>ly sep>at$4 ,yet m5tal evaluations & ideas are giv5 s mu* p[] t cognitive habits are responsible = emotional responses4 ,x is ?9k+ t makes x s4 ,rational-emotive !rapy is ! mo/ widespread approa* to cognitive !rapy1 s we w exam9e ,ellis's approa* 9 "s detail4 ,! ma9 te*nique ( rational-emotive !rapy1 & ( cognitive !rapy 9 g5]al1 is to focus cli5ts' att5tion on _! belief sy/ems1 _! views ab\t :at %\ld & ought to be1 _! cognitive filt]s ?r\gh :i* !y int]pret1 9 a semiautomatic way1 ! _w ar\nd !m4 ,if ! activat+ ev5t is a failure or a rejection1 = example1 a cli5t's rational belief sy/em w lead to feel+s ( regret1 sorr[1 disappo9tm5t1 or annoyance2 if an individual's beliefs are irrational1 on ! o!r h&1 he or %e may in/ead feel depression1 wor?lessness1 futility1 & sev]e anxiety4 ,= rational-emotive !rapy1 emotional good heal? dep5ds on ! rationality ( ! way a p]son receives & int]prets ev5ts4 ,,:at ,,rational-,,emotive ,,!rapy ,,is ,,l ,!rapy usually beg9s ) individual sessions4 ,once cli5ts h le>n$ h[ to id5tify m5tal habits t create di/urb+ emotions1 !rapy is sometimes cont9u$ 9 gr\ps1 :]e new attitudes & =ms ( behavior c be practic$ 9 a k9d ( microcosm ( ! l>g] _w4 ,rational-emotive !rapy t is done 9 a gr\p context is n1 h[ev]1 gr\p !rapy1 s9ce ! !rapi/'s focus is on individual /yles ( ?9k+1 n on relation%ips among memb]s ( ! gr\p4 ,dur+ !rapy1 cli5ts are v quickly *all5g$ to give evid5ce = _! irrational beliefs4 ,! rational-emotive !rapi/ w op5ly & ru?lessly oppose ! fooli% absolutes t cli5ts express & make x cle> h[ !y are upsett+ !mselves emotionally by insi/+ on su* nons5se4 ,x is n consid]$ ess5tial t ! !rapi/ be a k9d1 w>m1 #adb supportive p]son4 ,9 fact1 rational-emotive !rapy enc\rages !rapi/s to %[ _! impati5ce ) irrational beliefs t _c be def5d$ empirically or logically4 ,once cli5ts are %[n t _m ( _! beliefs cause !m mis]y & disappo9tm5t1 !y are ask$ to dispute--sil5tly1 9 _! own m9ds--_! irrational beliefs :5ev] !y f9d ! old habits tak+ ov]4 ,x takes "t to ext+ui% old habits2 x doesn't happ5 ov]night4 ,cli5ts ne$ pati5ce & t5acity to oppose _! old reflexes & replace !m ) rational1 reali/ic beliefs4 ,an h\r a week 9 rational-emotive !rapy is really1 !n1 l a tutorial session ) a tea*]4 ,! cli5t-/ud5ts talk ab\t _! feel+s2 ! !rapi/ criticizes und]ly+ irrational beliefs & makes x cle> to ! cli5ts :at a rational response w\ld be4 ,!n ! cli5ts are ask$ to practice apply+ rational beliefs on _! own1 outside ( !rapy4 ,gradually1 a m rational way ( look+ at ?+s takes ! place ( ! old habits4 ,,an ,,example ,joan ,h5dley is s+le1 tw5ty-n9e ye>s old1 & assi/ant manag] ( a bank4 ,%e has come to ,dr4 ,kovac because ( *ronic depression1 a s5se ( l[ self-wor?1 & feel+s ( insecurity & anxiety4 ,lately1 %e has begun to dr9k heavily & regul>ly feels ! ne$ to use sleep+ tablets4 ,! foll[+ is a sample ( _! dialogue dur+ _! fir/ session ( rational-emotive !rapy3 ,,dr4 ,k43 ,well1 :at w\ld y l to />t on8 ,,joan3 ,x's h>d to put x into words4 ,i guess x's t ,i've be5 depress$ a lot1 ab\t ev]y?+4 ,i feel l !re's no purpose to my life4 ,i don't "k :]e to g or h[ to decide4 ,,dr4 ,k43 ,s1 "r n[ y don't "k :]e y're head$4 ,:at's s t]rible ab\t t8 ,x w\ld be nice if y knew1 b y don't4 ,is t awful8 ,,joan3 ,yes1 x is6 ,ev]ybody %\ld h a purpose6 ,,dr4 ,k43 ,:y %\ld !y8 ,mo/ p g ?r\gh life )\t mu* ( a s5se ( purpose4 ,,joan3 ,well1 t's :at ,i believe 94 ,,dr4 ,k43 ,look1 ,joan1 y appe> to me to be an intellig5t p]son4 ,y & ,i c agree t x w\ld be m satisfy+ = y to h a s5se ( direction1 b y take ?is #adc "o m /ep1 & x's a v big /ep6 ,y ?9k x's t]rible t y don't feel !re's a purpose to y\r life "r n[4 ,y ?9k y %\ld h a purpose1 & ,i suspect y're puni%+ y\rself because y don't live up to t %\ld4 ,,joan3 ,b mo/ p believe 9 ?+s l t4 ,,dr4 ,k43 ,& a lot ( !m end up feel+ mis]able6 ,i "k3 ,i've se5 doz5s ( p sitt+ :]e y are1 & _! ?9k+ is *ock-full ( oughts1 %\lds1 & mu/s4 ,& t's :at makes !m feel upset4 ,!y feel mu* bett] :5 !y c come to say to !mselves1 ,x w\ld be nic]1 or m pleasant1 or bett] if ?+s 7 diff]5t4 ,,joan3 ,y mean1 if ,i c get rid ( %\lds & mu/s 9 my ?9k+1 ,i'd feel bett]8 ,,dr4 ,k43 ,t's exactly :at ,i'm say+4 ,if y 7 to foll[ :at ,i've told y1 y'd seldom be upset aga91 & probably nev] en\gh to get y\rself really depress$4 ,,joan3 ,uh-huh4 ,i'm n sure ,i really see h[ t c be4 ,i feel pretty /upid4 ,,dr4 ,k43 ,s "h y g aga96 ,y ?9k ( y\rself z a pretty bright p]son1 & s y say to y\rself1 ,i ought to be able to cat* on to any?+ pretty fa/4 ,& n[ "h y are1 & y're n all t sure y've foll[$ ev]y?+ already1 & s y tell y\rself1 ,oh my1 ,i mu/ be /upid4 ,,joan3 ,nods appreciatively1 laughs4 ,,dr4 ,k43 ,y don't h to upset y\rself4 ,y c *oose :at y tell y\rself1 & !n y'll h control ov] :at y feel4 ,tell me ab\t y\r job4 ,y're 9 ! role ( a lead]1 ar5't y8 ,,joan3 ,yes4 ,,dr4 ,k43 ,b y don't ?9k y're do+ a great job8 ,,joan3 ,no1 ,i don't4 ,,dr4 ,k43 ,b !y ?9k y're do+ ,,ok1 isn't t correct8 ,,joan3 ,yes1 b my job seems to be tak+ m & m out ( me4 ,beg9s to cry4 ,,dr4 ,k43 ,well1 x seems l y're do+ y\r job ,,ok2 x's j t y1 f y\r po9t ( view1 ar5't p]fect6 ,s !re=e x's all j empty pret5se3 y're j fak+ x6 ,b1 if y'll give up y\r nutty p]fectionism1 y'd be 9 ! cle>1 because y're obvi\sly satisfy+ p at "w2 y're satisfy+ _! expectations4 ,b s9ce y feel bad ab\t y\rself1 y say to y\rself1 ,well1 !y j hav5't f\nd me out6 ,:5 #add !y d1 ,i'm 9 = x4 ,& s y live 9 a /ate ( fe>4 ,,joan3 ,t's x4 ,,dr4 ,k43 ,x's all because ( y\r unreasonable expectations4 ,c y see t8 ,,joan3 ,at lea/ tempor>ily conv9c$4 ,yes1 ,i ?9k ,i c6 ,,dr4 ,k43 ,?is is :at ,i'd l to "w on ) y4 ,x's go+ to take "s self-discipl9e on y\r "p1 b toge!r we c help y get rid ( "s m5tal habits t br+ y unhapp9ess4 ,!y don't s]ve a useful purpose1 & !y drag y d[n4 ,:y don't y tell me m specifically :at upsets y at "w8 ,,applications ,,( ,,rational-,,emotive ,,!rapy ,al?\gh rational-emotive !rapy has be5 us$ to treat _m diff]5t k9ds ( problems1 ,ellis admits t 8 approa* is mo/ effective = ! treatm5t ( cli5ts ) a s+le major symptom or cli5ts :o are only mod]ately di/urb$4 ,9 addition1 ,ellis does advocate rational-emotive !rapy = individuals ^: patt]ns ( irrational ?\ght are sev]e1 b = su* individuals--:5 !y c be help$--!rapy is a long-t]m process4 ,f evaluative /udies complet$ s f>1 x appe>s t rational-emotive !rapy is especially effective 9 r$uc+ anxieties result+ f su* ?+s z public speak+1 relat+ to o!rs on an individual basis1 & fac+ old age4 ,o!r specific applications ( rational-emotive !rapy include ^!3 99 problems ( maladju/m5t1 :]e y h increas+ difficulty cop+ ) ei!r an already famili> environm5t or a situation new to y 99 m>ital problems & sexual difficulties 99 psy*osomatic problems 99 anxiety 99 depression 99 problems ( crim9als & del9qu5ts ,individuals :o are mo/ effectively treat$ ) =ms ( cognitive !rapy t5d to h "o or m ( ^! p]sonal *>act]i/ics3 #ade 99 ,!y t5d to ?9k 9 v rigid ways4 99 ,!y are incl9$ to ?9k 9 all-black1 or all-:ite t]ms4 ,!y are absoluti/s :o ?9k 9 t]ms ( :at is "r & :at is wrong4 ,life1 = !m1 is an uncompromis+ affair4 99 ,!y are (t5 p]fectioni/s ab\t !mselves1 s !y t5d to h unreali/ic expectations ( o!rs z well4 ,!y are ideali/ic4 99 ,_! behavior is frequ5tly uptight1 int5se1 judgm5tal1 & intol]ant or %y1 self-effac+1 & incl9$ to self-condemnation4 99 ,!y t5d to ?9k t if !re is "o bad apple1 ! :ole bu%el mu/ be rott54 ,!y t5d to magnify & exagg]ate evils4 99 ,!y confuse :at !y w\ld l to h ) :at !y believe !y absolutely ne$4 ,!y are dem&+ & exact+4 ,,exi/5tial-,,humani/ic ,,psy*o!rapy ,= individuals :o suff] f feel+s ( acute lonel9ess & empt9ess1 :o h lo/ fai? 9 !mselves or o!rs1 & :o t5d to be analytical & introv]t$4 ,!re is no s+le1 well-def9$ !ory accept$ by mo/ exi/5tial !rapi/s4 ,in/ead1 exi/5tial psy*o!rapy is a po9t ( view1 a g5]al philosophy t attempts to describe :at x means to be human & to live mean+fully 9 ! _w4 ,!re is1 nev]!less1 a cons5sus among exi/5tial !rapi/s conc]n+ ! objectives ( ! approa*4 ,exi/5tial !rapy seeks to help cli5ts a*ieve ^! goals3 99 to accept & make con/ructive use ( _! own p]sonal fre$om 99 to become au!ntic individuals1 %$d+ ! conv5tions & con=mities t obscure ! real p]sons !y are 99 to e/abli% human relation%ips bas$ on hone/y & p]sonal integrity 99 to be fully pres5t 9 ! imm$iacy ( ! mom5t #adf 99 to le>n to accept ! natural limits ( life ,exi/5tial !rapy _c be describ$ 9 t]ms ( a gr\p ( te*niques commonly us$ by !rapi/s4 ,9 fact1 exi/5tial !rapi/s are incl9$ to resi/ ! =mulation & application ( specific te*niques ( !rapy1 believ+ t psy*o!rapy is ess5tially a human endeavor & t ! drive to =mulate te*niques is basically a dehumaniz+1 objectify+ int]e/4 ,to und]/& exi/5tial !rapy1 !n1 we ought n to expect to enc\nt] a set ( specific te*niques4 ,:at really *>act]izes exi/5tial !rapy are its self-consci\sly endors$ attitudes ab\t life4 ,!y include ^! realizations3 99 ,anxiety frequ5tly motivates individuals to *ange _! lives4 ,anxiety (t5 is pres5t to tell y t y ne$ to *ange2 x is n necess>ily a bad feel+ f :i* no good w come4 99 ,ev5tually ea* ( u w die1 & clut*+ life anxi\sly w /& 9 ! way ( f9d+ real mean+ 9 liv+4 99 ,pa/ ev5ts ne$ n control :at y feel & d n[2 y are free to *ange old1 unsatisfy+ patt]ns4 99 ,guilt is (t5 a sign t y h miss$ opportunities = p]sonal gr[?3 y h n be5 true to y\rself & h s9n$ aga9/ y\rself 9 "s important way4 99 ,if y are to become a mature & g5u9e p]son1 y mu/ disc>d ! lies y h cultivat$4 ,among ^! is liv+ ! lie ( try+ n to be ! p]son y really are2 ano!r is ! lie ( try+ to be a p]son y are n1 & !re are _m o!rs4 99 ,to be cont5t )9 ! limitations ( life1 x is vital t y h a s5se ( y\r own value4 ,y become inau!ntic if y base y\r s5se ( self-e/eem on :at o!rs ?9k ( y4 ,x is obvi\s t individual responsibility is c5tral to exi/5tial !rapy4 ,y are responsible = ! p]son y *oose to become4 ,y may *oose to be g5u9e1 or y may *oose to lie to y\rself & o!rs4 ,x is :5 y abdicate responsibility = becom+ au!ntic t y w (t5 come to feel anxiety & a s5se ( guilt4 ,anxiety & guilt are (t5 pres5t1 9 o!r #adg words1 :5 !re is a fundam5tal lack ( congru5ce1 ( be+ :ole1 ( be+ 9 accord ) y\rself4 ,! ma9 contributors to exi/5tial psy*o!rapy h be5 ! ,swiss analy/s ,ludwig ,b9swang] 7#ahha-aiff7 & ,m$>d ,boss 7#aijc-aiij71 along ) ,rollo ,may 7#aiji-aiid71 :o 0 ! f\nd] ( exi/5tial psy*o!rapy 9 ,am]ica4 ,today1 exi/5tial psy*o!rapy is practic$ "u a v>iety ( names3 humani/ic psy*ology1 exp]i5tial psy*o!rapy1 & also 9 ! context ( ! relat$ approa*es1 logo!rapy & reality !rapy 7see ,*apt] #aa74 ,,:at ,,exi/5tial ,,!rapy ,,is ,,l ,exi/5tial psy*o!rapy is usually individual !rapy1 ) sessions commonly s*$ul$ a few times a week1 z 9 psy*oanalysis4 ,exi/5tial !rapy (t5 %[s its psy*oanalytic orig9s3 z 9 analysis1 exi/5tial psy*o!rapy focuses l>gely on anxiety & ! suppress$ issues t anxiety veils4 ,exi/5tial !rapi/s w pu% cli5ts to confront anxiety directly2 !y w try to und]/& ! cli5ts' anxiety 9 relation to ! lies t cli5ts tell !mselves 9 ord] to protect !mselves f m anxiety4 ,z we h already se51 exi/5tial !rapi/s v commonly reg>d anxiety & depression z promis+ symptoms because !y c %ake cli5ts out ( unfulfill+ patt]ns ( liv+4 ,anxiety & depression1 in/ead ( be+ view$ z undesirable symptoms to be elim9at$1 c motivate p to *ange & gr[4 ,consequ5tly1 exi/5tial !rapi/s t5d to disapprove ( ! use ( drugs 9 !rapy4 ,if cli5ts take pills to r$uce anxiety1 = example1 !y w r$uce ! aw>5ess ( motivat+ pa9 t1 if fac$ squ>ely1 may br+ ab\t a m mean+ful1 satisfy+ life4 ,"h is an example ( ! way an exi/5tial !rapi/ =ces a cli5t to face issues head-on4 ,:at ! !rapi/ is ?9k+ is 9 brackets4 ,,cli5t3 ,i don't "k :y ,i /ay ) my job4 ,x j makes me depress$4 ,all ,i d is tell y ! same ?+s ov] & ov]4 ,i'm n gett+ any:]e4 ,,!rapi/3 ,%e is compla9+ because ,i'm n cur+ h]4 ,%e has to d ?is h]self4 ,to be frank1 ,i'm impati5t1 #adh too4 ,we talk1 b y're n able to act4 ,%e has to see t ,i c't take responsibility = h] procra/9at+4 ,,cli5t3 ,:at d y ?9k ,i ought to d8 ,i c't keep liv+ l ?is4 ,,!rapi/3 ,i c't make h] decisions = h]4 ,i c't tell y :i* way to g4 ,i d "k t y've be5 avoid+ a decision4 ,i believe y're go+ to take *>ge ( y\r life b1 until !n1 we may bo? feel impati5t4444 ,:at d y want to d8 ,%e has to be pu%$ to make up h] m9d4 ,%e's ready n[ to decide b is und]/&ably sc>$4 ,,cli5t3 ,i want to /op worry+1 /op feel+ s anxi\s & upset4 ,,!rapi/3 ,%e'd l me to "m h]4 ,look1 ,diane1 y've be5 com+ to see me = ?ree mon?s n[4 ,y "k :at ,i ?9k ab\t feel+ upset3 if y're upset1 !re's some?+ bo!r+ y t y ne$ to pay att5tion to4 ,we bo? "k y dislike y\r job & t y /ay on ma9ly because y're afraid ( a *ange4 ,we c talk a long "t ab\t y\r unhapp9ess at "w & ab\t y\r fe> ( *ange1 b ev5tually x w be "t to /op talk+ & to try "s alt]natives4 ,d y ?9k y're ready8 ,i ?9k y are4 ,,cli5t3 7,sighs47 ,i guess y're "r4 ,i seem to be dragg+ my feet4 ,if ,i want a satisfy+ job1 ,i'm j go+ to h to try some?+ else4 ,c we talk ab\t "s ( my alt]natives1 !n1 & ,i'll try to /op compla9+6 ,,!rapi/3 ,n[ %e's />t+ to face up to ! *all5ge4 ,,applications ,,( ,,exi/5tial ,,psy*o!rapy ,^! are "s ( ! difficulties exi/5tial psy*o!rapy is design$ to treat3 99 feel+s ( real e/rangem5t or ali5ation f o!rs--f y\r imm$iate family & fri5ds or f neighbors or colleagues at "w 99 a s5se ( acute lonel9ess1 ( be+ cut (f f humanity & f normal ev]yday activities & int]actions 99 an aw>5ess t y\r life has become an empty patt]n #adi ( habit1 t y\r activities or "w no long] feel mean+ful or valuable 99 an inability to accept ! realities t limit life2 = example1 anxiety exp]i5c$ by old] p]sons z !y become m aw>e ( ! ne$ to face ! reality t life w end or ang] & fru/ration exp]i5c$ by individuals :o mu/ cope ) real limitations--p]sons ) physical impairm5ts & *ronic pa91 individuals ^: opportunities are limit$ by pov]ty1 by _! ties ( responsibility to o!rs1 or by social disadvantage ,individuals :o b5efit mo/ f exi/5tial psy*o!rapy t5d to h ^! *>act]i/ics3 99 ,!y are reflective & analytical4 99 ,!y t5d to be introv]t$4 99 ,!y h lo/ fai?--9 _! s5se ( social commitm5t1 9 _! id5tity & role )9 _! families1 9 _! belief t _! "w is ( value1 or 9 _! religion4 #aej #aa ,,psy*o!rapy1 ,,"p ,,ii ,logo!rapy1 ,reality ,!rapy ,adl]ian ,!rapy1 ,emotional ,flood+ ,!rapies1 ,direct ,decision ,!rapy ,9 ?is second *apt] devot$ to major approa*es to psy*o!rapy1 we w look at logo!rapy1 reality !rapy1 ,adl]ian !rapy1 ! family ( emotional flood+ !rapies1 & direct decision !rapy4 ,l ! five psy*o!rapies describ$ 9 ,*apt] #aj1 ^! focus special att5tion on a cli5t's p]sonal /yle ( relat+ to ! _w & o!rs4 ,!y all seek to help a p]son to free himself or h]self f tr\bl+ feel+s & negative attitudes & to replace ^! ) a /rong] & m confid5t self-concept4 ,ea* !rapy is a diff]5t pa? to t goal4 ,,logo!rapy ,= reflective individuals :o are s5sitive to values & :o are 9 se>* ( a ri*] s5se ( mean+ 9 life4 ,he :o has a :y to live = c be> ) almo/ any h[4 ,fri$ri* ,nietzs*e #aea ,viktor ,frankl 7#aije-aiig7 is wor?y ( mu* respect & admiration4 ,out ( ?ree t]rible ye>s ( suff]+ 9 a conc5tration camp1 dur+ :i* 8 "m1 fa!r1 bro!r1 & wife 7 tak5 f him1 ,dr4 ,frankl develop$ logo!rapy 7f ! ,greek logos1 r\ghly equival5t to mean+74 ,logo!rapy is an approa* to !rapy t addresses our inh]5t ne$ = mean+ & value 9 liv+4 ,! belief t su/a9$ ,dr4 ,frankl dur+ ?is p]iod ( int5se suff]+ 0 ! conviction t p1 9 spite ( great adv]sity1 angui%1 & ! loss ( all !y hold de>1 c rema9 free )9 !mselves & are able to ma9ta91 & ev5 to /r5g!n1 _! s5se ( self-respect & integrity4 ,to communicate h[ x is possible to d ?is became ,dr4 ,frankl's lifework4 ,logo!rapy is a !rapy ( mean+ = ^? :o are unable to f9d a reason = liv+4 ,x is a =m ( !rapy relat$ to exi/5tial analysis 7see ,*apt] #aj71 b x is specific 9 its conc]n = help+ cli5ts f9d :at x is t really matt]s to !m1 t makes h>d%ips & pa9 wor?:ile4 ,if ,freudian psy*oanalysis looks to ! pa/ = insight1 logo!rapy focuses in/ead on ! future1 on a p]son's life task4 ,9 ?is1 !re is no ab/ract & g5]al answ] to ! "q ,:at is ! mean+ ( life8 ,= ! mean+ ( life diff]s f man to man1 f day to day & f h\r to h\r4 ,:at matt]s1 !re=e1 is n ! mean+ ( life 9 g5]al b r ! specific mean+ ( a p]son's life at a giv5 mom5t4 ,to put ! "q 9 g5]al t]ms w\ld be comp>able to ! "q pos$ to a *ess ma/]1 ,tell me1 ,ma/]1 :at is ! be/ move 9 ! _w8 ,!re simply is no su* ?+ z ! be/ or ev5 a good move ap>t f a p>ticul> situation 9 a game & ! p>ticul> p]sonality ( "o's oppon5t4 ,! same holds = human exi/5ce4444 ,ev]yone has 8 own specific vocation or mission 9 life2 ev]yone mu/ c>ry out a concrete assignm5t t dem&s fulfillm5t4444 ,ultimately1 a man %\ld n ask :at ! mean+ ( life is1 b r mu/ recognize t x is he :o is ask$4 ,9 a ^w1 ea* man is que/ion$ by life2 & he c only answ] to life by answ]+ = 8 own life2 to life he c only respond by be+ responsible4#a #a ,viktor ,e4 ,frankl1 ,man's ,se>* = ,mean+3 ,an ,introduction to ,logo!rapy 7,new ,york3 ,wa%+ton ,squ>e ,press1 #aifc71 pp4 #agj-aga4 #aeb ,dr4 ,frankl lik$ to comp>e logo!rapy to ! role ( ! eye speciali/3 ! logo!rapi/'s role is to help ! pati5t see m cle>ly ! range ( liv$ values & mean+ available to him4 ,,:at ,,logo!rapy ,,is ,,l ,an eld]ly physician came to ,viktor ,frankl to ask = help ) sev]e depression4 ,8 wife1 :om he lov$ above all else1 _h di$ two ye>s be=e4 ,8 s5se ( loss w\ld n heal4 ,c\ld ,dr4 ,frankl help him8 ,dr4 ,frankl respond$ ) a "q3 ,:at w\ld h happ5$1 ,doctor1 if y _h di$ fir/1 & y\r wife _h _h to survive y8 ,oh1 he said1 = h] ?is w\ld h be5 t]rible2 h[ %e w\ld h suff]$6 ,y see1 ,doctor1 su* a suff]+ has be5 sp>$ h]1 & x is y :o h sp>$ h] ?is suff]+2 b n[1 y h to pay = x by surviv+ & m\rn+ h]4 ,! physician said no?+1 b rose to 8 feet1 %ook ,dr4 ,frankl's h&1 & calmly left 8 (fice4 ,suff]+ ceases to be suff]+ 9 "s way at ! mom5t x f9ds a mean+1 su* z ! mean+ ( sacrifice4#b ,x is ! basic conc]n ( logo!rapy to help pati5ts see ! mean+ 9 _! lives4 #b ,frankl1 ,man's ,se>* = ,mean+1 pp4 #agh-agi4 ,logo!rapy is kn[n = two te*niques endors$ by ,viktor ,frankl4 ,he call$ !m d]eflection & p>adoxical int5tion4 ,_m emotional problems h _! roots 9 :at psy*o!rapi/s call anticipatory anxiety3 a woman :o is afraid ( blu%+ :5 %e ent]s a room fill$ ) p w t5d to blu%4 ,a man :o fe>s impot5ce & :o tries to a*ieve an erection w (t5 fail4 ,a woman :o willfully tries to a*ieve orgasm also w frequ5tly fail4 ,^! are examples ( excessive1 or hyp]-1 reflection4 ,excessive1 anxi\s att5tion is paid to :at we fe> or wi%1 br++ ab\t ! v ?+ we are try+ to avoid4 ,frankl develop$ specific ways ( refocus+ or re*annel+ ?is excessive att5tion4 ,d]eflection c\ld take ! =m1 = example1 ( p]suad+ ! blu%+ woman to conc5trate on p>ticul> ?+s :5 %e ent]s a cr[d$ room3 to look = acqua9tances1 to admire :at someone may be we>+1 or to #aec look = objects 9 ! room to appreciate1 = example4 ,9 ! case ( impot5ce or frigidity1 (t5 a %ift ( att5tion f y\rself to y\r p>tn]'s pleasure w elim9ate anticipatory anxiety4 ,frankl describes an attempt to help a bookkeep] :o 0 9 real despair & close to suicide4 ,= sev]al ye>s he _h suff]$ f writ]'s cramp3 v real muscul> cramps t r$uc$ 8 legible script to an illegible scrawl4 ,he 0 9 dang] ( los+ 8 job4 ,he 0 treat$ ) p>adoxical int5tion4 ,he 0 ask$ to write 9 an int5tionally illegible scrawl4 ,b he f\nd t :5 he delib]ately tri$ to scrawl1 he c\ld n4 ,)9 two days1 8 writ]'s cramp _h vani%$4 ,simil> approa*es h be5 v effective--& long-la/+--9 c]ta9 cases ( sev]e /utt]+1 uncontroll$ %ak+1 wa%+ compulsions1 insomnia1 sexual difficulties1 & o!r problems4 ,logo!rapi/s t5d to be w>m1 accept+ individuals4 ,!y w (t5 use humor4 ,yet !y are tra9$ to confront individuals3 to pu% _! cli5ts to face _! inn] feel+s ( futility & despair1 & !n1 out ( _! (t5 ov]look$ & und]e/imat$ inn] res\rces & moral /r5g?1 to w t _! lives become mean+ful4 ,logo!rapi/s try to enc\rage cli5ts to see m cle>ly :at x is t gives !m a s5se ( value 9 liv+ & to use :at !y see to direct !mselves t[>d m satisfy+ & p]sonally fulfill+ lives4 ,,applications ,,( ,,logo!rapy ,z we h already obs]v$1 logo!rapy has be5 us$ to treat a wide range ( individual problems involv+ a loss ( fai? 9 ! value ( liv+1 behavior t no long] is "u volunt>y control1 or behavior t fru/rates y\r desires4 ,logo!rapy is especially well-suit$ to help+ individuals ) nog5ic neuroses1 ,frankl's t]m = p]sonal problems t h _! basis 9 conflicts betwe5 oppos+ values4 ,nog5ic 7f ! ,greek n\s1 mean+ _s or m9d7 neuroses h _! orig9 9 p]sonal moral or spiritual1 b n necess>ily religi\s1 conflicts4 ,!y lead to a feel+ ( exi/5tial fru/ration3 a p]son's w to f9d mean+ is block$4 ,:5 suffici5t pressure is built up1 anxiety & depression c foll[4 ,y c imag9e h[ pressure might build up 9 ! inn] lives #aed ( a bus9ess executive :o wi%es %e _h a family in/ead ( a c>e] id5tity1 a univ]sity pr(essor :o ye>ns to be an indep5d5t arti/1 or a f9ancially successful bus9essman :o despises 8 own pret5ses & opportunism4 ,i ask$ ! poor creatures :o li/5$ to me att5tively 9 ! d>kness ( ! hut to face up to ! s]i\sness ( our position4 ,!y mu/ n lose hope b %\ld keep _! c\rage 9 ! c]ta9ty t ! hopelessness ( our /ruggle did n detract f its dignity & mean+4 ,i said t someone looks d[n on ea* ( u 9 difficult h\rs--a fri5d1 a wife1 somebody alive or dead1 or a ,god--& he w\ld n expect u to disappo9t him4 ,he w\ld hope to f9d u suff]+ pr\dly--n mis]ably4#c #c ,frankl1 ,man's ,se>* = ,mean+1 p4 #acb4 ,,reality ,,!rapy ,= p]sons able to make a commitm5t to a plan = life improvem5t1 :e!r !y h emotional or behavioral problems or simply want to develop a success-id5tity4 444 ,unhapp9ess is ! result & n ! cause ( irresponsibility4 ,william ,glass]1 ,reality ,!rapy ,reality !rapy 0 develop$ 9 ! #aiejs by psy*iatri/ ,william ,glass] 7#aibe-bjac74 ,8 approa* to !rapy evolv$ z a result ( 8 "w ) del9qu5t te5age girls1 ) cli5ts 9 private practice1 & ) sev]ely tr\bl$ pati5ts 9 a ,,va hospital4 ,reality !rapy1 z ! "n implies1 attempts to help by /r5g!n+ a p]son's practical und]/&+ ( reality & by enc\rag+ concrete plann+ t w br+ ab\t an improv$ s5se ( p]sonal adju/m5t to reality4 ,x emphasizes a v practical1 feet-on-!-gr\nd focus on ! pres5t3 a p]son's pa/ exp]i5ce _c be rewritt54 ,reality !rapi/s d n believe 9 ! ess5tial value ( psy*oanalytic int]pretation1 dream analysis1 nondirective c\nsel+1 or intellectual #aee insight4 ,a reality !rapi/ focuses on ! pres5t1 specifically on attempts pati5ts may n[ be mak+ to become m successful f _! own po9ts ( view4 ,if a pati5t is n able to make def9ite plans ( ?is k9d & _c su/a9 a commitm5t to !m1 ! focus ( reality !rapy w be to enc\rage ! pati5t to beg9 to d ?is4 ,x is an approa* t believes t a /rong s5se ( p]sonal id5tity c come only f do+3 if an individual is able to develop a degree ( self-responsibility t is solid & ent]pris+1 a feel+ ( p]sonal success & effectiv5ess w foll[4 ,reality !rapi/s are oppos$ to mak+ diagnoses4 ,a diagno/ic label frequ5tly adds a burd5 to individuals :o are already burd5$ by emotional1 family1 or adju/m5t problems4 ,glass] notes1 = example1 t be+ label$ a s*izophr5ic c be worse ?an ! disease z f> z incapacitat+ "o 9 ! c\rse ( life's activities4#d #d ,william ,glass] & ,leon>d ,m4 ,zun91 ,reality ,!rapy1 9 ,raymond ,j4 ,cors9i1 ed41 ,curr5t ,psy*o!rapies 7,itasca1 ,,il3 ,f4 ,e4 ,peacock ,publi%]s1 #aigi71 p4 #cbi4 ,reality !rapi/s c resi/ diagnos+ & label+ _! cli5ts because _! approa* claims t p]sonal psy*ological difficulties1 except ^? due to physical illness 7see ,*apt] #h71 result f a lack ( p]sonal discipl9e & responsibility4 ,p are (t5 caught 9 ! habit ( blam+ _! failures on _! families1 _! lack ( opportunity1 _! race1 pov]ty1 & o!r outside =ces4 ,x is a habit ) a dead end3 x ignores ! pot5tial success t c come f initiative motivat$ by responsibility & moral c\rage4 ,z ,erne/ ,hem+way said :5 ask$ if he ev] anticipat$ failure1 ,if y anticipate failure1 y'll h x4 ,,! ,,exp]i5ce ,,( ,,reality ,,!rapy ,x isn't h>d to ga9 a feel+ = :at reality !rapy is l4 ,^! are ! basic pr9ciples ( ! approa*3 ,! relation%ip betwe5 !rapi/ & cli5t mu/ be p]sonal4 ,! !rapi/ tries to make cle> t he is a g5u9e p]son :o has1 9 "s areas ( 8 life1 be5 able to plan effectively & to develop a s5se ( p]sonal success4 ,! focus ( individual sessions is on :at ! cli5t does1 n on :at he or %e may feel4 ,behavior c be *ang$ mu* m #aef directly ?an feel+s1 & feel+s soon fall into place once behavior is m satisfy+4 ,:at is important is = ! cli5t to develop intellig5t plans & !n to "w to c>ry !m ?r\gh4 ,if c]ta9 goals are n realiz$1 ! !rapi/'s conc]n is to enc\rage ! cli5t to take ! next practical /ep1 r ?an to sp5d "t & en]gy analyz+ :at w5t wrong4 ,! reality !rapi/ accepts t ! fir/ /eps are (t5 halt+ ones4 ,x is important n to be disconc]t$ by occasional /umbl+ & a few falls4 ,:at is ess5tial is a commitm5t to self-discipl9e & progress1 refus+ to puni% y\rself :5 a plan may n succe$1 b go+ beyond x ) a positive attitude t ev5tually c become a habit4 ,glass] gives ?is illu/ration ( ! p]si/5t refocus+ on practical issues t *>act]izes reality !rapy3 a te5age girl expresses to h] !rapi/ t %e w\ld l to look = a job4 ,! !rapi/ does n respond1 ,good1 let me "k h[ x works out1 b in/ead beg9s ! foll[+ ex*ange4#e ,,!rapi/3 ,:at day next week8 ,,girl3 ,i don't "k4 ,i ?\ght ,monday or ,tuesday4 ,,!rapi/3 ,:i* day8 ,monday or ,tuesday8 ,,girl3 ,well1 ,i guess ,tuesday4 ,,!rapi/3 ,y guess1 or w x be ,tuesday8 ,,girl3 ,tuesday4 ,,!rapi/3 ,:at "t ,tuesday8 ,,girl3 ,well1 sometime 9 ! morn+4 ,,!rapi/3 ,:at "t 9 ! morn+8 ,,girl3 ,oh1 well1 #i3cj4 ,,!rapi/3 ,f9e1 t is a good "t to beg9 look+ = a job4 ,:at d y plan to we>8 #e ,glass] & ,zun91 ,reality ,!rapy1 ,curr5t ,psy*o!rapies1 p4 #cbd4 ,9 ano!r example ( reality !rapy1 a pati5t says1 ,i feel depress$ & mis]able4 ,in/ead ( respond+1 ,h[ long h y felt ?is way8 or ,:at h y be5 feel+ depress$ ab\t81 a reality !rapi/ might ask1 ,:at h y be5 do+ t cont9ues to make y depress$8 or ,:y ar5't y ev5 m depress$8 ,) bo? ( ^! responses1 ! !rapi/ makes x cle> t he believes ! cli5t c influ5ce 8 or h] feel+s4 ,(t5 !rapi/s1 no matt] :at _! approa*1 w say to #aeg cli5ts :o are go+ ?r\gh a difficult "t t !y may phone aft] h\rs if !re is an em]g5cy4 ,a reality !rapi/ may1 9 addition1 also say1 ,i hope y'll call me if y h _h a special success4 ,,applications ,,( ,,reality ,,!rapy ,reality !rapy has be5 us$ 9 connection ) ^! types ( problems3 99 individual problems involv+ anxiety1 m>ital conflicts1 maladju/m5t1 & "s psy*oses :]e a p]son is comp>atively out ( t\* ) reality & may h halluc9ations or delusions 99 te5age del9qu5cy 99 difficulties fac$ by wom5 :o h rec5tly be5 wid[$ 99 design+ s*ool programs t /ress ! developm5t ( individual id5tity bas$ on a s5se ( p]sonal success ,reality !rapi/s believe t _! approa* is ( value to p :o want to develop a m successful patt]n ( liv+1 ( manag+ _! own affairs1 & ( cop+ effectively ) *all5ges at "w & ) problems ( ev]yday liv+4 ,reality !rapy has also be5 us$ 9 indu/ry ) organizational problems & ) difficulties exp]i5c$ by individual employees4 ,reality !rapy is n useful 9 treat+ problems 9 :i* !re is sev]e )drawal 7z 9 autism7 or cases involv+ s]i\s m5tal ret>dation4 ,to be effective1 reality !rapy presupposes t cli5ts are able to communicate & are bo? will+ & able to cultivate habits ( self-discipl9e & p]sonal responsibility4 ,,adl]ian ,,psy*o!rapy ,= individuals int]e/$ 9 p]sonal gr[?1 especially 9 social directions1 & = p]sons ) l[ self-e/eem :o feel block$ & disc\rag$ ab\t life4 #aeh ,! greate/ pr9ciple ( liv+ is to love "o's neighbor z oneself4 ,rabbi ,akiva1 writ+ #b1jjj ye>s ago ,alfr$ ,adl] 7#ahgj-aicg7 0 a contempor>y ( ,freud4 ,e>ly 9 8 c>e]1 ,adl] 0 invit$ by ,freud to p>ticipate 9 8 special circle ( pr(essionals int]e/$ 9 ! developm5t ( psy*oanalysis4 ,adl]'s already =mulat$ views 7 n 9 accord ) ,freud's1 _! diff]5ces became m pron\nc$1 & ,adl] ev5tually sep>at$ himself f psy*oanalysis4 ,freud 0 embitt]$ & became a lifelong enemy ( ,adl]4 ,9 contra/ to ,freud's te*nical & ab/ract !ory1 ,adl]'s is humani/ic1 op51 & concrete4 ,:]e ,freudian analysis believes t emotional di/urbances h a sexual basis1 ,adl]ian !rapy claims t neurosis comes ab\t ?r\gh di/ort$ p]ceptions & f habits & attitudes t are le>n$4 ,9 ,adl]'s sy/em ( individual psy*ology1 !re is no conc]n = unconsci\s processes or = int]nal divisions ( ! self into id1 sup]ego1 & ego4 ,adl]ians /ress t a p]son =ms a unity & mu/ be treat$ z a :ole4 ,adl]'s approa* to psy*o!rapy is bas$ on ! view t feel+s ( inf]iority are normal4 ,!y exi/ 9 *ildr51 & !y cont9ue to be pres5t 9 adults :o may feel weak psy*ologically1 socially1 or because ( physical limitations4 ,to comp5sate = feel+s ( inf]iority1 adults /rive = sup]iority by deal+ effectively ) ! _w1 or !y become deeply disc\rag$ 7h[ev]1 !y are n consid]$ to be sick7 & lose contact ) positive1 con/ructive activities4 ,adl] also po/ulat$ t emotional difficulties come ab\t :5 y are conv9c$ t y simply _c solve ! problems ( life 9 a way t is compatible ) a ne$ to be sup]ior 9 "s way4 ,c]ta9 attempts to comp5sate = feel+s ( inf]iority c lead to emotional problems lat]4 ,!y include seek+ a feel+ ( sup]iority by requir+ att5tion f o!rs1 /riv+ = p[] ov] o!rs1 tak+ rev5ge1 & giv+ up--decl>+ t y _c cope because ( p]sonal defici5cies & weakness4 ,*ildr5 f families :]e !re is di/ru/1 dom9ation1 abuse1 or neglect t5d to *oose ^! pa?s4 ,ano!r facet ( ,adl]'s approa* is t individuals :o #aei _c comp5sate = feel+s ( inf]iority are incl9$ to make a numb] ( basic mi/akes 9 p]ceiv+ ! _w4 ,!y w ov]g5]alize 7,nobody c>es ab\t me471 depreciate _! wor? 7,i'm j a h\sewife471 set unreali/ic goals 7,i %\ld please ev]yone471 di/ort 7,y h to lie to get ahead471 & hold faulty values 7,w91 ev5 if y h to climb ov] o!rs474 ,f9ally1 ,adl] felt t1 ov] ! c\rse ( _! lives1 _m p /r5g!n ^! basic mi/akes :ile 9 pursuit ( ! ultimately unsatisfy+ desires = att5tion1 p[]1 rev5ge1 or escape4 ,_! /yles ( liv+ may lead to depression1 *ronic anxiety1 crime1 alcoholism1 drug abuse1 & o!r problems4 ,,:at ,,adl]ian ,,!rapy ,,is ,,l ,adl]ian !rapi/s try to help p *ange unfulfill+ patt]ns ( liv+ 9 sev]al ways4 ,fir/1 & p]haps mo/ important1 is ! belief t !rapy %\ld d m ?an help cli5ts ) imm$iate problems4 ,x %\ld help !m develop an adequate philosophy ( life1 enc\rage !m to cultivate an approa* to liv+ t is self-su/a9+1 positive1 & inh]5tly social 9 focus4 ,! p>adox ( inf]iority & l[ self-e/eem is t ! suff]+ !y cause disappe>s once p c =get !mselves & beg9 liv+ to "s ext5t = o!rs4 ,adl] w\ld rem9d 8 cli5ts to consid] f "t to "t h[ y c give ano!r p]son pleasure4#f ,adl]ian !rapy /resses ! importance ( social goals4 ,= ,adl]1 we are =emo/ social creatures2 our individual id5tities c be develop$ & our problems resolv$ only 9 a social context4 #f ,alfr$ ,adl]1 ,problems ( ,neurosis 7,new ,york3 ,h>p] & ,r[1 #aifd71 p4 #aja4 ,s9ce ,adl] believ$ t mo/ emotional difficulties we exp]i5ce result f feel+s ( inf]iority t h l$ to disc\ragem5t1 ! second goal ( ,adl]ian !rapi/s is to (f] enc\ragem5t4 ,!y are z mu* conc]n$ ) mirror+ cli5ts' /r5g?s z !y are ) analyz+ _! problems4 ,adl]ian !rapi/s w devote a good deal ( att5tion to id5tify+ & enc\rag+ ! p]sonal assets ( ea* cli5t4 ,adl] sugge/$ sev]al te*niques t h also come to be us$ by o!r s*ools ( psy*o!rapy3 #afj ,act+ ,z ,if ,frequ5tly1 cli5ts express a wi% to beg9 act+ 9 new ways--to be m ass]tive1 to make an ef=t to break out ( conf9+ patt]ns ( liv+1 to conqu] c]ta9 fe>s4 ,h[ev]1 !y usually feel t ! new behaviors are phony1 s !y are reluctant to try4 ,adl] sugge/$ t cli5ts try a new behavior = ! next week only z !y w\ld try on new clo?+3 !y ne$ only act z if4 ,adl] f\nd t1 z cli5ts began to act diff]5tly1 !y w\ld beg9 to feel diff]5tly4 ,:5 _! feel+s 7 positive1 !y t5d$ to make new ways ( behav+ "p ( !mselves4 7,behavior modification1 describ$ 9 ! next *apt]1 builds on ?is idea47 ,p>adoxical ,int5tion ,we enc\nt]$ ?is te*nique1 also call$ negative practice1 9 ! prec$+ section on logo!rapy4 ,x c be a v effective te*nique :5 c]ta9 habits c no long] be controll$4 ,if y suff]$ f insomnia1 y w\ld be ask$ to focus y\r att5tion on /ay+ awake3 to put an end to ! habit1 y w\ld be ask$ to amplify x4 ,oddly en\gh1 9 _m cases1 ?is judo-l dropp+ ( resi/ance & r$irection ( att5tion c br+ involunt>y behavior back "u control4 ,! ,pu%-,button ,te*nique ,_m ( u h unpleasant ?\ghts & emotions t refuse to leave u4 ,we f9d ourselves on famili> tracks t we "k lead to sadness1 regret1 ang]1 panic1 or fru/ration4 ,b we c't seem to subdue :at ,z5 calls ^! *att]+ monkeys ( ! m9d4 ,adl] taught cli5ts t !y c\ld create :atev] feel+s 9 !mselves !y wi%$1 simply by decid+ :at to ?9k4 ,x is possible1 ) "s practice1 to imag9e a happy or peaceful memory or sc5e & to direct y\r att5tion to x :5 negative ?\ghts try to dom9ate4 ,we all h ?is pu% button available4 ,l all ex]cises 9 self-discipl9e1 x /r5g!ns u ! m we use x4 7,cognitive !rapy1 discuss$ 9 ,*apt] #aj1 is especially conc]n$ ) ?is influ5ce ( ?\ghts on emotions47 ,,sett+s ,,= ,,!rapy ,adl]ians use a v>iety ( sett+s = !rapy4 ,individual #afa !rapy is common1 b sometimes two !rapi/s may "w toge!r ) "o cli5t1 an approa* t gives cli5ts an exp]i5ce ( coop]ation betwe5 pr(essionals :o may p]ceive !m diff]5tly4 ,adl]ian work%ops are popul> ) p>5ts conc]n$ ) problems 9 re>+ *ildr54 ,o!r work%ops exi/ = m>ri$ c\ples4 ,adl]ians h (t5 be5 innovative3 ,rudolf ,dreikurs1 a well-kn[n /ud5t ( ,adl]1 01 = example1 "o ( ! fir/ !rapi/s to use gr\p !rapy 9 private practice4 ,,applications ,,( ,,adl]ian ,,psy*o!rapy ,because ,adl] did n view human problems z =ms ( sickness1 ,adl]ians see emotional & behavioral difficulties z blocks t p enc\nt] 9 _! attempts to realize !mselves4 ,_m ( ! problems ,adl]ian !rapi/s treat are !re=e consid]$ to be normal problems ( liv+ fac$ by normal p4 ,_m cli5ts ent] !rapy to le>n ab\t !mselves & to gr[4 ,adl]ians h work$ ) a wide range ( cli5ts ) a wide range ( human problems3 99 cli5ts int]e/$ 9 p]sonal developm5t 99 individuals :o h become deeply disc\rag$ ab\t _! lives 99 c\ples & families 99 del9qu5ts & crim9als ,,emotional ,,flood+ ,,!rapies ,today !re are ?ree ma9 v>ieties ( emotional flood+ !rapies3 bio5]getics1 primal !rapy1 & implosive !rapy4 ,!y %>e ! c5tral belief t1 by tax+ y1 pu%+ y to exp]i5ce fru/ration1 ang]1 or anxiety1 ! !rapi/ may help y a*ieve a la/+ s5se ( emotional relief & well-be+4 ,^! ?ree !rapies d1 h[ev]1 v>y a good deal 9 ! te*niques !y use to enc\rage cli5ts to exp]i5ce /rong emotions4 ,bio5]getics makes use ( an unusual approa* to physical ex]cise4 ,primal !rapy enc\rages cli5ts to relive e>ly pa9ful memories4 ,implosive !rapy asks cli5ts to use imag]y to increase1 9 a controll$ mann]1 feel+s t cause emotional di/ress4 ,^! approa*es %>e ! assumption t #afb emotional difficulties c be help$ by a direct release ( feel+s t h come to be block$4 ,,bio5]getics ,= rigid1 inhibit$ p :o h p5t-up feel+s 9 ne$ ( release4 ,alex&] ,l[5 7#aiaj-bjjh7 0 tra9$ z a physician & !n z a psy*oanaly/ "u ! direction ( ,au/rian psy*oanaly/ ,wilhelm ,rei* 7#ahig-aieg74 ,rei* believ$ t emotional problems result$ f sexual repression4 ,he 0 a social revolution>y 9 8 attempts to br+ ab\t sexual fre$om4 ,he became a controv]sial figure & 0 n able to put 8 ideas on a s]i\s & pr(essionally respectable foot+4 ,l[5 0 int]e/$ 9 ! !rapeutic implications ( ,rei*'s "w4 ,he develop$ an approa* to !rapy t emphasizes n sexual lib]ation & pleasure z ,rei* did1 b a s5se ( fre$om t he felt c\ld result only f an approa* to ! body t all[s y to drop t5se muscul> armor & to feel integrat$ & fully alive4 ,l[5 f\nd t emotionally tr\bl$ p 7 physically knott$ & rigid & t5d$ to brea! 9 a %all[ & con/rict$ way4 ,l[5 devis$ a v>iety ( physical ex]cises1 su* z hold+ y\r body 9 an ar*$ position until exhau/ion sets 91 mak+ contact ) ! floor only ) h&s1 head1 & feet4 ,^! ex]cises c cause en\gh /ress to ar\se int5se emotions3 cry+ out1 collaps+1 feel+ rage or t5d]ness4 ,z ^! p5t-up feel+s are releas$1 _m cli5ts (t5 discov] an increase 9 positive emotional /r5g?4 ,bio5]getic !rapi/s (f] individual !rapy z well z work%ops4 ,!y t5d to act z tea*]s1 po9t+ out v bluntly h[ a cli5t's physical rigidities reflect rigid qualities ( p]sonality3 ,y\r *e/ muscles are ?is t5se because y h be5 def5d+ y\rself s long1 l a box]1 or ,y\r jaw muscles a*e because y've be5 bit+ back angry impulses4 ,because ( its physical approa* to human emotions1 bio5]getics is sometimes reg>d$ z ! ,we/'s !rapeutic v]sion ( yoga4 7,= a discussion ( yoga1 see ,*apt] #ae47 #afc ,applications ( ,bio5]getics ,bio5]getics appe>s to be mo/ useful = p ) any ( ^! *>act]i/ics3 99 ,_! feel+s are m>k$ly inhibit$1 or !y feel dead5$ emotionally4 99 ,!y feel impair$ sexually or d n exp]i5ce orgasm = nonphysical reasons4 99 ,!y are rigid1 uptight1 & incl9$ to be obsessive p]fectioni/s4 99 ,!y h p5t-up feel+s ( ang]1 ho/ility1 or grief t are 9 ne$ ( an outlet4 ,bio5]getics is n ! treatm5t ( *oice :5 deep] insight & self-k are important4 ,bio5]getic !rapi/s are n 9 g5]al especially conc]n$ ) a cli5t's p]sonal hi/ory1 family & "w environm5t1 or specific adaptation problems4 ,,primal ,,!rapy ,= individuals :o cont9ue to suff] f *ildhood pa94 ,ar?ur ,janov 7#aibd- 7 0 psy*oanalytically tra9$ z a cl9ical psy*ologi/ & psy*iatric social work]4 ,he _h be5 practic+ = sev5te5 ye>s :5 a %y & )drawn cli5t 9 a gr\p !rapy session let out a pi]c+1 primitive scream4 ,! inhibit$ cli5t exp]i5c$ a s5se ( release & insight4 ,?is ev5t fasc9at$ ,janov & ev5tually trans=m$ 8 pr(essional p]spective4 ,he develop$ an approa* to !rapy t enc\rages pati5ts to re-exp]i5ce repress$ pa9ful memories f *ildhood4 ,janov calls ^! primal pa9s3 !y come ab\t :5 a *ild's emotional ne$s repeat$ly are n met4 ,! inn] suff]+ t results is suppress$2 ! pa9 _c be dissipat$4 ,x takes en]gy to cont9ue to block out pa9ful feel+s4 ,! con/ant exp5diture ( en]gy !n %[s up 9 consci\s t5sion4 ,janov came to believe t emotional problems 9 adults /em f #afd _! unwill+ness to exp]i5ce feel+s t a *ild w\ld f9d cru%+ b--?\gh pa9ful--c n[ be fac$4 ,:5 primal pa9 is fac$1 ,janov claims1 individuals ga9 a degree ( fre$om & maturity !y c\ld n o!rwise a*ieve4 ,janov's primal !rapy is be/ kn[n = ! primal scream we m5tion$ above t "s pati5ts let out :5 !y confront ! pa9 !y h suppress$ = s long4 ,primal !rapy enc\rages a repeat$ ca?>tic release ( p5t-up feel+s4 ,dur+ ! fir/ ?ree critical weeks ( !rapy 7:i* normally co/ 9 excess ( #b1jjj71 ! primal !rapi/ is on call tw5ty-f\r h\rs a day = a s+le pati5t4 ,! pati5t is isolat$ = ! fir/ week 9 a hotel room1 )\t ,,tv1 cig>ettes1 alcohol1 sex1 or companion%ip1 & has daily !rapy sessions ) ! !rapi/ t la/ f two to ?ree-&-a-half h\rs4 ,pati5ts !n sp5d six to twelve mon?s 9 a primal !rapy gr\p4 ,janov has be5 criticiz$ = 8 app>5t desire = public *>isma & = capitaliz+ on adv]tis+ hype4 ,he t5ds n to reveal 9 writ+ details ( 8 proc$ures 9 !rapy & w %>e 8 pr(essional secrets only ) initiates at 8 primal !rapy in/itute4 ,comp>atively few !rapi/s h _h ?is special tra9+4 ,h[ev]1 _m !rapi/s (f] :at !y claim is ! equival5t ( primal !rapy1 :i* !y call int5sive feel+ !rapy4 ,!y h ! same =mat = !rapy3 isolation 9 a hotel room1 ?ree weeks' exclusive att5tion to ea* cli5t1 & ! result+ high fees4 ,applications ( ,primal ,!rapy ,primal !rapy has be5 us$ to treat ^! problems3 99 *ronic depression & anxiety 99 compulsions 99 phobias 99 drug addiction 99 problems ( homosexuals 99 m>ital problems ,l bio5]getics1 primal !rapy is be/ suit$ = individuals :o h repress$ or p5t-up feel+s !y h n f\nd ways to release4 #afe ,x is important to be> 9 m9d t primal !rapy is initially "o ( ! mo/ exp5sive !rapies1 s9ce x devotes exclusive att5tion to ea* cli5t at ! beg9n+ ( !rapy4 ,x may n be ! !rapy ( *oice = m v]bal1 intellectual cli5ts :o want to develop an und]/&+ ( !mselves beyond an exp]i5ce ( ca?>sis4 ,,implosive ,,!rapy ,= p ) phobias4 ,?is emotional flood+ !rapy 0 develop$ by ,?omas ,/ampfl 7#aibc- 74 ,/ampfl 0 tra9$ z a cl9ical psy*ologi/ at ,loyola ( ,*icago & 0 influ5c$ by bo? psy*oanalysis & ! psy*ology ( le>n+4 ,e>ly 9 8 c>e]1 he became conv9c$ t cli5ts ) phobias t5d to re9=ce _! fe>s by automatically avoid+ :at !y fe>4 ,he develop$ an approa* to help p face ! situations1 feel+s1 or memories !y mo/ fe>4 ,/ampfl's approa* is mo/ easily und]/ood 9 ! light ( rec5t exp]im5tal "w on animal avoidance behavior4 ,a dog1 = example1 is conf9$ 9 a cage t is divid$ 9 two4 ,a l[ wall sep>ates ! two halves ( ! cage1 ov] :i* ! dog c jump4 ,on "o side !re is a bell t r+s j be=e ! dog receives an electric %ock4 ,! dog promptly le>ns t he c avoid ! %ock by jump+ to ! o!r side ( ! cage4 ,soon he w le>n to d ?is automatically1 :5ev] ! bell r+s4 ,:at is significant f a psy*ologi/'s po9t ( view is t ! dog w cont9ue = a long "t to jump to ! opposite side ( ! cage1 ev5 once no fur!r %ocks are giv54 ,! dog's fe> is ma9ta9$ 9 =ce only by 8 own memory4 ,animal psy*ologi/s h f\nd a quick way to end ! dog's fe>3 r+ ! bell1 b prev5t ! dog f jump+ to ! o!r side ( ! cage4 ,once ! anxiety-/rick5 animal realizes t he is no long] go+ to be %ock$1 ! old habit bas$ on fe> simply disappe>s4 ,implosive !rapi/s make use ( an equival5t te*nique ) human be+s4 ,pati5ts are ask$ to imag9e1 z vividly z #aff possible1 t !y are fac+ ! v ?+ !y *ronically h tri$ to avoid4 ,= example1 an individual may h suff]$ f a t]rify+ fe> ( elevators = ye>s4 ,! !rapi/ tries to use exagg]at$ imag]y to produce maximum anxiety4 ,he might ask ! pati5t to imag9e be+ /uck 9 an elevator fifty floors up1 hav+ ! elevator %ake & abruptly fall a foot1 !n h ! lights g out1 & s on4 ,by ma9ta9+ ?is contriv$ elevator nightm>e long en\gh1 implosive !rapi/s claim t1 frequ5tly1 ! level ( anxiety ( pati5ts quickly & dramatically falls1 & !y lose _! exagg]at$ fe>s4 ,implosive !rapi/s are !re=e n prim>ily conc]n$ ) be+ g5u9e1 sympa!tic1 or mo!r+4 ,!y focus _! en]gy & att5tion on pu%+ cli5ts to confront ! wor/ fe>s & cata/rophes !y c imag9e4 ,all ! :ile1 cli5ts are aw>e bo? t ! int5se anxiety !y exp]i5ce is an int5d$ goal ( !rapy & t ! !rapi/ is conv9c$ !y are mu* /rong] ?an !y h ?\ght4 ,implosive !rapy is usually done on an individual basis & is comp>atively brief1 usually la/+ less ?an a doz5 sessions4 ,x %\ld be m5tion$ t1 :5 n successful1 implosive !rapy may occasionally s5sitize cli5ts to feel ev5 m anxiety ?an !y did at ! outset4 ,x !re=e t5ds to be a high]-risk treatm5t1 b x c be rem>kably effective4 ,visualiz+ anxiety-produc+ ev5ts also has successfully be5 us$ by individuals on _! own4 7,= m in=mation1 see ,app5dix ,b3 ,sugge/ions = ,fur!r ,read+47 ,applications ( ,implosive ,!rapy ,implosive !rapy is especially appropriate = ! treatm5t ( phobic individuals :o *>act]i/ically t5d to avoid c]ta9 k9ds ( behavior1 situations1 or objects because ( ! sev]e anxiety & agitation ^! produce 9 !m4 ,implosive !rapy1 :5 effective1 c be dramatically effective 9 a comp>atively %ort "t4 ,h[ev]1 less ardu\s approa*es to !rapy c (t5 be z effective & may involve less risk ( increas+ a cli5t's exi/+ anxiety4 ,alt]native %ort-t]m !rapies especially well-suit$ to ! treatm5t ( phobias include behavior modification 7,*apt] #ab71 ,ge/alt !rapy 7,*apt] #aj71 reality !rapy 7e>li] 9 ?is *apt]71 primal #afg !rapy 7e>li] 9 ?is *apt]71 & bi(e$back1 relaxation tra9+1 & hypnosis 7,*apt] #ae74 ,,direct ,,decision ,,!rapy ,= individuals capable ( ex]cis+ det]m9ation & self-discipl9e :o e>ne/ly desire to *ange4 ,if !re's "o ?+ my exp]i5ce z a psy*o!rapi/ has taught me1 x is t no "o has to be a victim4 ,h[ev] important ext]nal factors l heal?1 physical appe>ance1 & upbr++ may be1 !y don't h to det]m9e ! happ9ess quoti5t 9 anyone's life /ory4 ,! way we exp]i5ce our lives is1 q simply1 up to u4 ,h>old ,gre5wald1 ,! ,happy ,p]son ,at ! "t ( ?is writ+1 ! majority ( academic & rese>* psy*ologi/s reg>d !mselves basically z ,freudians4 ,yet mo/ psy*iatri/s1 psy*o!rapi/s1 social work]s1 & c\nselors h mov$ beyond ,freud's =mal categories & made use ( _! own common s5se & int]pretive abilities4 ,h>old ,gre5wald's emphasis on ! c5tral role ( *oice 9 mak+ fundam5tal life decisions implicitly repres5ts ! approa* ( a great _m !rapi/s & c\nselors today4 ,8 conception ( !rapy is casual1 simple1 & (t5 good-humor$4 ,gre5wald 7#aiaj-bjaa7 0 orig9ally tra9$ z a psy*oanaly/4 ,z ,gre5wald ga9$ pr(essional exp]i5ce1 h[ev]1 8 p]spective began to *ange4 ,he gradually came to believe t _m pati5ts _h1 at "s critical mom5t1 made a decision to g crazy4 ,!re 0 a po9t :5 !y c\ld ex]cise control1 & at t mom5t1 !y *ose to be depress$ or anxi\s1 to )draw completely into catatonia1 to become s*izophr5ic1 alcoholic1 or :atev] _! decision might be4 ,i discov]$ 9 work+ ) p :o h _h psy*otic breaks 444 t mo/ ( !m describ$ a p>ticul> mom5t :5 !re 0 a *oice ( :e!r to /ay 9 control or let g4444 ,y w f9d1 aga9 & aga91 if y speak to pati5ts :o h brok5 d[n1 & if y se>* = x1 t !re is always #afh a po9t at :i* !y _h a *oice1 & x is at t po9t t !y /ill h ! possibility ( controll+ !mselves4 ,if !y h confid5ce 9 _! ability to control !mselves !y c ex]cise x4#g #g ,h>old ,gre5wald1 ,treatm5t ( ! ,psy*opa?1 9 ,raymond ,j4 ,cors9i1 ed41 ,read+s 9 ,curr5t ,p]sonality ,!ory 7,itasca1 ,,il3 ,f4 ,e4 ,peacock ,publi%]s1 #aigh71 p4 #cee4 ,?is *oice po9t t p exp]i5ce became ! focus ( ,dr4 ,gre5wald's direct decision !rapy4 ,,an ,,example ,"h is "o ( ! mo/ dramatic examples ( 8 approa*3 ,dr4 ,gre5wald _h be5 invit$ to give a demon/ration ( direct decision !rapy at a m5tal hospital 9 ,norway4 ,he ask$ = a volunte] f ! inmates1 someone :o c\ld speak ,engli%4 ,a tw5ty-ye>-old pati5t nam$ ,m>ie came =w>d4 ,%e _h ! appe>ance ( a back w>d s*izophr5ic4 ,%e 0 hagg>d1 wild-ey$1 & unkempt4 ,"h is ,dr4 ,gre5wald's description ( _! op5+ conv]sation3#h #h ,h>old ,gre5wald & ,elizabe? ,ri*1 ,! ,happy ,p]son 7,new ,york3 ,/e9 & ,day1 #aihd71 pp4 #ahj-aha4 ,i ge/ur$ t[>d a *air4 ,won't y sit d[n1 please8 ,:5 ,i'm ready4 ,i'll sit :5 ,i'm ready4 ,w\ld y tell me y\r "n8 ,%e wav$ an arm t[>d ! /aff memb] seat$ beh9d me4 ,y he>d him4 ,m>ie1 my "n is ,,m>ie6 ,i'm sorry1 ,m>ie1 ,i didn't cat* x at fir/4 ,n[ ,i wond] if !re is any?+ ,i c d = y4 ,w\ld y l me to help y8 ,y c't help me1 none ( y c help me4 ,:y don't y leave me alone8 ,,:y ,,are ,,y ,,always ,,at ,,me8444 ,%e ru%$ on1 %\t+ at ! top ( h] voice & us+ a mixture ( expletives & obsc5ities t %[$ an admirable comm& ( ,engli% z well z ,norwegian4 ,no?+ ,i c\ld d c\ld make ! situation worse1 s ,i decid$ to try some?+ dra/ic4 ,i out%\t$ h]4 ,,cut ,,x ,,out1 ,,m>ie6 ,,y ,,"k ,,y ,,don',t ,,h ,,to ,,talk ,,l ,,t4 ,%e /opp$ sudd5ly & focus$ on me = ! fir/ "t4 ,! muscles 9 h] face relax$ ev] s slightly1 & h] eyes #afi %[$ aw>5ess & intellig5ce4 ,h['d y "k8 ,i />$ at h] = a m9ute1 giv+ h] my be/ foxy-gr&pa look4 ,x takes "o to "k "o1 ,i said f9ally--at :i* po9t ,m>ie's face broke into a gr94 ,y mean y're crazy8 ,y too8 ,p]haps4 ,& p]haps ! only diff]5ce betwe5 y & me is t ,i "k h[ to act sane4 ,m>ie seem$ to l ! s\nd ( t4 ,%e tight5$ ! sa% ( h] ba?robe & sat d[n4 ,z ,m>ie calm$ d[n1 %e agre$ t %e w\ld l ,dr4 ,gre5wald to help h]4 ,%e want$ badly to leave ! in/itution4 ,,dr4 ,g43 ,if y really want to get out1 ,m>ie1 y'll h to make a v simple decision4 ,,m>ie3 ,:at's t8 ,,dr4 ,g3 ,decide to act sane4 ,dr4 ,gre5wald ask$ h] to ?9k ( ! b5efits1 ! pay(fs1 t came to h] z a result ( h] crazy behavior4 ,!re 7 a numb] ( major pay(fs3 %e didn't h to look aft] h]self1 didn't h to look = a job1 didn't h to li/5 to h] "m4 ,! up%ot 0 t ,m>ie decid$ to give up be+ crazy & to return to ev]yday liv+4 ,x w\ld h be5 easy = ,dr4 ,gre5wald to conclude t %e _h be5 fak+ all ! ye>s %e 0 9 ! m5tal in/itution4 ,b %e _h n be5 play-act+4 ,yet h] illness began ?r\gh a *oice %e _h made1 & x end$ ! same way4 ,leav+ ! hospital _w 0 n easy = h]4 ,9 fact1 x 0 (t5 v difficult4 ,b %e /ay$ ) h] decision & (t5 _h to reaffirm x4 ,%e m>ri$ & _h a *ild4 ,%e wrote to ,dr4 ,gre5wald3 ,i f\nd myself beg9n+ to drift (f1 drift out ( my life1 ! way ,i us$ to4 ,&--,i didn't6 ,i decid$ to be ! k9d ( p]son1 ! k9d ( wife & "m1 t ,i want to be4 ,n p]fect1 j :at's possible4 ,& if ,i drift (f1 ,i won't be able to he> my daught]1 ,i'll be j l my "m 0 ) me4 ,m>ie w5t back to s*ool & e>n$ a degree 9 psy*ology4 ,aft] h] exp]i5ce1 %e 01 %e felt 7z did ,dr4 ,gre5wald71 9 #agj a special position to be helpful to o!r p 9 suff]+4 ,,:at ,,direct ,,decision ,,!rapy ,,is ,,l ,on y\r own or ) pr(essional help1 ! tru? ab\t y--:oev] y are--is t y c>ry )9 y\rself ! res\rces to heal y\r mo/ griev\s pa9s1 ov]come y\r mo/ p>alyz+ fe>s1 devise +5i\s solutions to y\r mo/ burd5some problems4 ,h>old ,gre5wald1 ,! ,happy ,p]son ,dur+ ! fir/ session ) a cli5t1 ,dr4 ,gre5wald (t5 says some?+ l1 ,d y want me to conc5trate on y\r problems1 or w\ld y l u to "w toge!r 9 mak+ y happy8 ,imm$iately1 he sugge/s to cli5ts t 9 fact !y are able to *ange & become happi]4 ,dr4 ,gre5wald describes sev5 phases t direct decision !rapy involves3 #a4 ,decide :at y want 9 ord] to be happy 7or happi]74 #b4 ,f9d ! decision beh9d ! problem3 :at has y\r implicit decision be5 9 y\r life t has e/abli%$ an unhappy1 or less happy1 patt]n8 ,gre5wald calls ^! life decisions3 !y =m ! c5t] ar\nd :i* y organize y\r life4 ,!y are responsible = y\r attitudes1 p]ceptions1 :at y value mo/1 & y\r behavior4 ,if y\r life decision is to suff]1 y w int]pret ev]y?+ t happ5s to y z m suff]+-to-be-endur$4 ,if y are prais$1 y may "q :e!r ! praise has an ult]ior motive4 ,suff]]s 444 h ! ability to snat* disa/] f e victory4#i #c4 ,:5 0 ! orig9al decision made8 ,did y\r life decision come f y\r upbr++8 ,did y inh]it x f y\r p>5ts8 #d4 ,id5tify ! pay(fs = ! decision4 ,ev5 extreme unhapp9ess--*ronic cl9ical depression--c h real pay(fs3 release y f responsibilities1 ga9 y att5tion f o!rs1 all[ y to return to ! com=t ( *ildhood dep5d5cy1 etc4 ,anxiety c give y good reasons = #aga disqualify+ y\rself f /ressful situations & re9=ce y\r belief t y _c cope4 #e4 ,:at are y\r alt]natives to ! behavior t is caus+ a problem8 ,x is (t5 h>d to see t y are n really trapp$ 9 a /ate ( unhapp9ess4 ,!re are always alt]natives4 #f4 ,*oose y\r alt]native & put x into practice4 ,tru/ y\rself4 ,happy p h a s5se t :atev] happ5s1 ?+s w ev5tually "w out4 ,9 %ort1 !y tru/ !mselves to react 9 _! own be/ int]e/4#aj #g4 ,support y\rself 9 c>ry+ out y\r decision4 ,habits die sl[ly4 ,y mu/ be pati5t4 ,y\r decision has to be made ov] & ov] aga91 j z an ov]weight p]son :o loves food mu/ decide aga9 & aga9 to say ,no to ?is dess]t today1 ! bak$ potato tomorr[4 ,gradually1 ! /r5g? ( y\r decision builds z y build /r5g? into x4 #i ,gre5wald & ,ri*1 ,! ,happy ,p]son1 p4 #bi4 #aj ,gre5wald & ,ri*1 ,! ,happy ,p]son1 p4 #bi4 ,,applications ,,( ,,direct ,,decision ,,!rapy ,z we h se51 direct decision !rapy is bas$ on ! assumption t y are able to beg9 to ex]cise self-discipl9e & t y are will+ to give up ! real pay(fs t be+ emotionally tr\bl$ frequ5tly does a*ieve4 ,^! int]relat$ ?+s--ability & will+ness to *ange--simply are n pres5t 9 _m p :o ent] !rapy4 ,!y come to !rapy = a v>iety ( o!r1 (t5 unconsci\s1 reasons3 = tempor>y com=t+1 = escape f an upsett+ situation or environm5t1 or = a *ance to release pa9ful feel+s & to express pa9ful ?\ghts4 ,cli5ts come 9 ord] to procra/9ate2 !y come to prove to !mselves t !y simply c't *ange & t ! !rapi/ j isn't good en\gh4 ,!y come out ( ang]1 fru/ration1 despair4 ,b comp>atively few ent] !rapy because !y really are p]suad$ !y c *ange & are committ$ to br++ *ange ab\t4 ,^! p are unque/ionably ! mo/ promis+ c&idates = any approa* to psy*o!rapy4 ,cli5ts :o come to !rapy = o!r reasons make up ! daily *all5ge & ! daily fru/ration1 conc]n1 worry1 & hope ( ! !rapi/4 ,! !rapi/ believes t1 9 "t1 & ) prop] treatm5t1 #agb p :o are imprison$ )9 walls ( _! own habits c rally ! det]m9ation & fai? to te> !m d[n & to ga9 a measure ( p]sonal fre$om4 ,9 ?is au?or's judgm5t1 direct decision !rapy1 p]haps m ?an any o!r approa*1 relies on a cli5t's det]m9ation & p]sev]ance4 ,if ^! p]sonality qualities are !re1 or if !y c successfully be enc\rag$ by a good !rapi/1 ! approa* c be effective ) a v wide range ( problems4 ,what 444 _m 444 pati5ts prov$ to me is t1 giv5 ! *oice to be happy1 _m unhappy p are able to decide t happ9ess is :at !y want4 ,!n 444 !y develop ! ability to exp]i5ce _! problems 9 a diff]5t way4#aa #aa ,gre5wald & ,ri*1 ,! ,happy ,p]son1 p4 #ec4 #agc #ab ,,behavioral ,,psy*o!rapy ,= p :o want prompt relief f specific symptoms & :o h ! inc5tive & discipl9e to practice new patt]ns ( behavior4 ,mu* ( our suff]+ is j s obscure 444 frigidity1 social anxiety1 isolation1 bor$om1 dissatisfaction ) life--9 all su* /ates we may see no correlation betwe5 ! inn] feel+ & ! way we live1 yet no su* feel+ c be indep5d5t ( behavior2 & if only we f9d connections we may beg9 to see h[ a *ange 9 ! way we live w make = a *ange 9 ! way we feel4 ,alan ,:eelis1 ,! ,des]t ,_m ( u today feel =c$ to adapt to ways ( liv+ t w lead to unhapp9ess1 lonel9ess1 fe>1 & illness4 ,is unlock+ all five bolts on "o's ap>tm5t door 9 ! morn+1 *eck+ t ! c ( ,mace is 9 y\r purse1 jo9+ ! sidewalk cr[d to ! subway1 hop+ y are n mugg$ 7or worse71 & !n sp5d+ ! daylight h\rs 9 a w9d[less (fice1 9 an atmosph]e ( t5sion1 pressure1 competitiv5ess1 & cig>ette #agd smoke1 ) "t out = caffe9e 7or1 aga91 worse7 & !n a lun* soak$ 9 alcohol a desirable & heal?y way to live8 ,behavioral psy*o!rapy seems to h be5 develop$ to respond especially to pres5t ne$s4 ,cli5ts usually respond 444 ) a great s5se ( relief on f9d+ !y are n se5 z sick or weak2 !y appreciate ! positive ori5tation t[>d *ang+ ! problematic situation r ?an dwell+ on x4#a #a ,dianne ,l4 ,*ambless & ,alan ,j4 ,gold/e91 ,behavioral ,psy*o!rapy1 9 ,raymond ,j4 ,cors9i1 ed41 ,curr5t ,psy*o!rapies 7,itasca1 ,il43 ,f4 ,e4 ,peacock ,publi%]s1 #aigi71 p4 #bcd4 ,behavioral psy*o!rapy is be/ kn[n = focus+ on symptoms z its ma9 t>get1 r ?an view+ symptoms z signs ( und]ly+ problems4 ,l mo/ g5]alities1 ?is "o has its exceptions2 "s behavioral psy*o!rapi/s are v mu* conc]n$ ) und]/&+ ! und]ly+ causes ( an individual's difficulties4 ,nev]!less1 behavioral !rapies d t5d to aim = concrete1 specific1 & prompt relief ( symptoms4 ,!y frequ5tly are effective1 & !y are bas$ on te*niques t h be5 te/$ ext5sively4 ,,! ,,?ree ,,s*ools ,today !re are ?ree ma9 s*ools ( behavioral psy*o!rapy3 ,,c\nt]-,,condition+ ,also call$ reciprocal inhibition1 ?is approa* 0 develop$ by ,joseph ,wolpe 7#aiae-aiig71 a ,jewi% psy*iatri/ tra9$ 9 ,s\? ,africa4 ,anxiety is (fset by means ( des5sitization1 ass]tiv5ess tra9+1 & sex !rapy4 ,z ! basis = des5sitization1 deep relaxation is us$ to inhibit anxiety4 ,ass]tiv5ess tra9+ is us$ to c\nt]act anxiety due to excessive %yness or aggressiv5ess by help+ individuals =m balanc$ habits ( ass]tiv5ess t are nei!r submissive nor ho/ile4 ,sex !rapy makes use ( te*niques ( relaxation & des5sitization to p]mit cli5ts to feel sexual ar\sal &1 9 ?is way1 to ov]come sexual anxiety4 #age ,,behavior ,,modification ,?is approa* 0 d]iv$ f ! "w ( ,am]ican behaviori/ ,b4 ,f4 ,sk9n] 7#aijd-aiij7 & o!rs1 :o attempt$ to %[ t a great _m emotional problems result f situations 9 :i* a p]son has be5 puni%$4 ,he or %e comes to fe> ^! situations & develops emotional symptoms 9 an ef=t to escape f !m4 ,9 behavior modification1 attempts are made to *ange behavior ?r\gh ! use ( rew>ds or puni%m5ts4 ,,cognitive ,,approa*es ,,to ,,behavior ,,*ange ,^! approa*es make use ( te*niques develop$ outside ( behavioral psy*o!rapy1 especially ^? ( ,alb]t ,ellis's rational-emotive !rapy 7see ,*apt] #aj74 ,^! cognitive approa*es are bas$ on ! belief t a p]son c ga9 control ov] undesirable behavior & psy*osomatic problems by le>n+ new habits ( ?9k+4 ,^! ?ree s*ools ( behavioral psy*o!rapy claim t ! problems lead+ p to ent] !rapy are le>n$ & c be unle>n$ ?r\gh sy/ematic tra9+4 ,9 p>ticul>1 anxiety--! prim>y s\rce ( emotional discom=t--c become a le>n$ habit4 ,:5 ?is happ5s1 anxiety is l9k$ to /imuli t 9 !mselves are usually h>mless4 ,a p]son may come to feel extremely anxi\s1 = example1 :5 9 ! pres5ce ( p 9 au?ority1 :5 9 b$ ) a sex p>tn]1 :5 ne> dogs or insects1 :5 criticiz$ by o!rs1 :5 9 a conf9$ space1 or 9 any numb] ( o!r situations4 ,anxiety 9 ^! situations is le>n$1 & x gradually becomes an involunt>y habit4 ,b ! habit frequ5tly c be brok5 & elim9at$4 ,,:at ,,behavioral ,,psy*o!rapy ,,is ,,l ,,c\nt]-,,condition+ ,:5 y are expos$ to a situation t y believe is ?reat5+1 y\r blood pressure & pulse rate g up1 y\r muscle t5sion increases1 ! blood supply to y\r l>ge muscle gr\ps increases1 circulation to y\r /oma* & g5itals is #agf r$uc$1 y\r pupils may dilate1 y\r m\? may get dry4 ,a />tl+ noise or a physical %ock c produce ^! symptoms4 ,!y are ! physical manife/ations ( anxiety1 & !y are ! focus ( c\nt]-condition+ te*niques4 ,anxiety g5]alizes v easily4 ,if y 7 repeat$ly puni%$ = play+ ) dirt z a *ild1 dirt c evoke /rong anxiety 9 y z an adult4 ,if y 7 bitt5 by a dog1 ! sight ( a dog ye>s lat] may make y feel anxi\s4 ,anxiety c come to be associat$ ) almo/ any exp]i5ce4 ,:at is p>ticul>ly de/ructive ab\t ?is is t y soon f9d y\rself caught 9 a vici\s circle3 a c]ta9 situation makes y anxi\s1 y try to avoid ! situation & ! anxiety x produces 9 y1 & z y d ?is1 y build up second>y anxiety--y get anxi\s t y'll get anxi\s4 ,s anxiety comp\nds1 fe$+ on itself1 fuel+ itself4 ,c\nt]-condition+ !rapi/s h f\nd t1 to v>y+ degrees1 we are all capable ( inhibit+ anxiety4 ,a behavior !rapi/ tries to tea* y h[ to d ?is1 ev5tually s t y c use relaxation te*niques on y\r own4 ,! foll[+ are ! ma9 phases ( des5sitization !rapy--ass]tiv5ess tra9+ & sex !rapy are simil>1 gradual1 & reassur+ processes3 #a4 ,y are taught h[ to a*ieve a /ate ( relatively complete physical relaxation4 ,_m !rapi/s w tape relaxation in/ructions s t y c practice daily at home = tw5ty to ?irty m9utes4 ,"s !rapi/s w in/ruct y to t5se y\r arms1 hold ! t5sion = t5 seconds or s1 !n relax & feel ! result+ s5se ( relaxation1 ! s5se ( relief f t5sion & /ra94 ,or1 "s !rapi/s use sugge/ion1 ask+ y to imag9e t y\r arms are becom+ heavi] & heavi]1 enc\rag+ y to relax deeply4 ,ea* ( y\r major muscle gr\ps is relax$ 9 turn until y feel fully relax$4 ,?is fir/ phase ( !rapy usually takes f two to six sessions4 #b4 ,next a hi]>*y is con/ruct$ by ! !rapi/ = ea* individual cli5t1 rank+ situations or /imuli f mo/ to lea/ anxiety-produc+4 ,a p]son :o fe>s to leave ! s5se ( security ( home already is aw>e ( su* a hi]>*y3 l[ anxiety may be felt on ! front /eps1 great] anxiety :5 go+ out to ! mailbox1 m #agg anxiety 9 walk+ ar\nd ! block1 & extreme anxiety :5 fac+ a trip or a move to ano!r resid5ce4 #c4 ,! la/ phase is ! actual process ( des5sitization4 ,y are ask$ to relax deeply ) eyes clos$1 usually 9 a recl9] 9 ! !rapi/'s (fice4 ,y are ask$ to imag9e a sc5e tak5 f ! l[-anxiety end ( y\r hi]>*y4 ,! !rapi/ tries to describe ! sc5e z reali/ically & vividly z possible4 ,if y beg9 to feel anxi\s1 y c raise an index f+]1 & !n ! !rapi/ w %ift away f ! imag9$ sc5e & w turn back to relaxation in/ructions4 ,:5 y are aga9 relax$1 ! process cont9ues until1 9 "t1 y are able to imag9e a sc5e high on ! hi]>*y1 b /ill su/a9 deep relaxation4 ,once ?is process ( des5sitization c be accompli%$ 9 ! (fice1 y beg9 anew1 b n[ ) actual situations--fir/ ) ^? l[ on y\r hi]>*y & !n work+ y\r way t[>d situations t us$ to cause y high anxiety4 ,frequ5tly1 behavior !rapi/s w accompany _! cli5ts outside ! (fice1 help+ !m to rema9 relax$--e4g41 :ile rid+ elevators1 9 cr[ds1 ev5 sometimes on airl9e flights if fe> ( fly+ is ! problem4 ,,behavior ,,modification ,! c5tral idea beh9d behavior modification is t undesirable habits ( behavior w gradually be elim9at$ if1 consi/5tly1 !y are n rew>d$ or ev5 are puni%$4 ,conv]sely1 desirable habits are enc\rag$ :5 !y consi/5tly are re9=c$ or rew>d$4 ,!rapi/s :o use behavior modification te*niques may recomm5d bo? puni%m5ts & rew>ds to cli5ts4 ,if y are a *ronic smok] or ov]eat]1 = example1 y may be giv5 a small device ) :i* to %ock y\rself mod]ately ea* "t y rea* = a cig>ette or a second help+4 ,or1 y may be ask$ to deposit #ajj ) ! !rapi/1 & a c]ta9 am\nt w be donat$ to y\r mo/ dislik$ political gr\p ea* "t y g a/ray4 ,rew>ds1 on ! o!r h&1 include mat]ial rew>ds t cli5ts may promise !mselves once a habit is successfully "u control = a c]ta9 l5g? ( "t4 ,mo/ !rapi/s #agh enc\rage y ev5tually to sub/itute inn] satisfactions3 pride 9 y\r slim appe>ance or improv$ heal?1 /r5g!n$ self-confid5ce1 gr[? ( sexual satisfaction1 &1 mo/ importantly1 a develop+ s5se ( self-respect z y le>n to ga9 control ov] anxiety1 fru/ration1 or dissatisfaction4 ,behavior !rapi/s also use di/raction te*niques4 ,!y enc\rage y to d ?+s t are incompatible ) ! problem y wi% to resolve4 ,bicycl+ or lovemak+ may prove to be good antidotes = "s individuals :o ov]eat4 ,hik+ or jogg+1 or physical reassurance1 massage1 or relax+ ba?s may less5 anxiety4 ,laught] releases t5sions & (f]s its own special k9d ( enc\ragem5t & heal?i] p]spective4 ,behavior modification requires /rong initiative & discipl9e on ! "p ( ! cli5t4 ,m ?an ^!1 x requires t y be will+ to let g ( old habits t h be5 unsatisfy+ or de/ructive & "w to =m new1 m rew>d+ habits4 ,9 ! beg9n+1 =c+ y\rself to behave 9 new ways may feel l pret5se or di%one/y4 ,?is is a common exp]i5ce & %\ld n be all[$ to block y\r desire to *ange4 ,unfamili> & ev5 uncom=table ways ( behav+ d become famili> & m com=table ! m !y are practic$4 ,if ^! new ways ( behav+ come to (f] satisfactions or comp5sations t old habits did n1 !y w gradually be absorb$ into y\r own s5se ( p]sonal id5tity4 ,:at at fir/ may feel to y l an act sl[ly is made a "p ( y\r p]sonality until a habit is e/abli%$ t feels entirely natural4 ,?is takes "t1 pati5ce1 practice1 & m practice4 ,,cognitive ,,approa*es ,,to ,,behavior ,,*ange ,behavioral psy*o!rapi/s use a v>iety ( te*niques design$ to help cli5ts control _! own behavior & individual physical responses m effectively4 ,bi(e$back ,bi(e$back c help _m p ga9 control ov] habitual1 automatic processes4 ,bi(e$back equipm5t c be us$ to tea* y h[ to r$uce t5sion1 develop skills to br+ ab\t relaxation1 or cope m successfully ) *ronic pa94 7,= a detail$ discussion ( bi(e$back1 see ,*apt] #ae47 #agi ,?\ght ,/opp+ ,?\ght /opp+ c help y break *a9s ( negative & self-und]m9+ ?\ghts4 ,?\ght /opp+ is a te*nique t beg9s by hav+ y ?9k out l\d dur+ !rapy sessions4 ,if y repeat$ly express negative1 tr\bl+ ?\ghts1 ! !rapi/ %\ts1 ,/op6 ,9 ?is way1 y are made acutely aw>e ( self-de/ructive ?9k+ habits4 ,y gradually le>n to /op y\rself f trapp+ y\rself 9 upsett+ ?\ghts by sil5tly comm&+ y\r m9d to /op6 ,x is a simple b (t5 effective te*nique1 relat$ to two te*niques we h already discuss$3 ! pu%-button te*nique ( ,adl]ian psy*o!rapy 7see ,*apt] #aa7 & ! te*nique ( disput+ y\r own irrational beliefs 9 rational-emotive !rapy 7see ,*apt] #aj74 ,problem ,solv+ & ,decision ,mak+ ,^! te*niques h be5 develop$ to help cli5ts solve p]sonal problems & make life decisions m effectively4 ,behavioral !rapi/s :o (f] assi/ance ( ?is k9d emphasize ! importance 9 problem solv+ & decision mak+ ( sev]al factors4 ,"o is refra9+ f implem5t+ solutions or decisions until y h cle>ly def9$ & und]/ood y\r problem or situation4 ,ano!r is becom+ aw>e ( emotional blocks to solv+ problems & mak+ decisions4 ,= example1 procra/9at+ s]ves to protect p f fac+ risks4 ,individuals are frequ5tly also det]r$ f solv+ practical problems because !y are emotionally di/ract$ by o!r difficulties t dem& att5tion fir/4 ,& p are incl9$ to jump at "o possible solution t !n acts z a bl9d] to see+ o!r pot5tially m promis+ alt]natives4 ,behavioral !rapi/s also believe y mu/ realize t1 (t51 difficulties y exp]i5ce :5 try+ to solve problems or make decisions are due to conflicts betwe5 incompatible goals or values4 ,sometimes "o objective _c be a*iev$ )\t compromis+ ano!r4 ,!y also believe y mu/ develop abilities to imag9e a wid] range ( alt]natives4 ,& f9ally1 !y believe y mu/ become bett] able bo? to =esee likely p]sonal consequ5ces ( implem5t+ a p>ticul> solution or decision & to evaluate ^! 9 relation to :at is p]sonally mo/ important4 #ahj ,,an ,,example ,,( ,,behavioral ,,psy*o!rapy ,anne ,holt 0 ?irty-two :5 %e came to see ,dr4 ,cantwell4 ,%e 0 noticeably anxi\s1 wr++ h] h&s1 t5se1 & easily />tl$1 z :5 a c>'s exhau/ backfir$ 9 ! /reet bel[4 ,%e compla9$ ( feel+ unlov$ by h] husb& & 0 always 9 dread ( 8 criticisms4 ,%e also felt h] "m-9-law 0 v critical ( h]4 ,anne want$ to get away f ! h\se b _h quit two jobs 9 succession1 9 ea* in/ance :5 h] boss's criticism ( h] "w upset h]4 ,dr4 ,cantwell expla9$ ! rationale beh9d des5sitization to h] & taught ,anne h[ to practice sy/ematic muscle relaxation1 beg9n+ by t5s+ h] h&s1 !n relax+ !m1 t5s+ !m1 !n relax+ !m aga91 & do+ ?is ) h] arms1 %\ld]s1 calf muscles1 ?ighs1 abdom51 jaw1 neck muscles1 *eek1 & m\? muscles4 ,he record$ 8 in/ructions on a tape = h] to use at home4 ,aft] five weeks ( daily practice1 ,anne 0 usually able to relax deeply 9 less ?an a m9ute4 ,dr4 ,cantwell1 9 ! meantime1 _h ga9$ a cle>] idea ( :at tr\bl$ ,anne1 & he _h made up ! foll[+ hi]>*y3 ,criticism direct$ at ,anne f3 ,high anxiety ,h] husb& ,8 "m ,a boss ,anne's "m ,l[ anxiety ,anne's neighbor ,dr4 ,cantwell decid$ to use a comb9ation ( des5sitization & ass]tiv5ess tra9+ ) ,anne4 ,dur+ half ( ea* weekly session ) ,dr4 ,cantwell1 ,anne 0 ask$ to relax 9 a recl9] ) h] eyes clos$1 & ,dr4 ,cantwell w\ld !n describe situations l[ on h] hi]>*y4 ,anne 0 to try to ma9ta9 h] s5se ( relaxation 9 spite ( ,dr4 ,cantwell's description ( an imag9$ situation involv+ ,anne's neighbor4 ,%e 0 to imag9e t h] neighbor1 :o 0 v fa/idi\s ab\t h] own y>d1 knock$ at ,anne's door to compla9 ab\t ,anne's habit ( sett+ ! tra% out ! night be=e pickup4 ,gradually1 9 a simil>ly concrete way1 ,dr4 ,cantwell _h ,anne imag9e h] "m criticiz+ ,anne = us+ ! same sponge = wip+ up #aha 9 ! kit*5 z = wa%+ ! di%es2 a boss ask+ ,anne to retype a bus9ess lett] us+ ano!r =mat t he pref]r$2 ,anne's "m-9-law dropp+ ! h9t t h] son lik$ to h 8 ,t-%irts iron$2 ,anne's husb& compla9+ because ,anne always ov]cook$ ! s(t-boil$ eggs4 ,dur+ ! second half ( ea* session ) ,anne1 ,dr4 ,cantwell play$ roles ) ,anne 9 :i* he taught h] h[ to ass]t h]self m 9 situations involv+ criticism4 ,9 "o session1 = example1 he took ! "p ( ,anne's "m & *ose a typical rem>k %e might make3 ,annie1 de>1 don't y ?9k x w\ld be sm>t] to use a diff]5t sponge = wip+ ! kit*5 c\nt]8 ,y %\ld use a sep>ate "o = ! di%es4 ,dr4 ,cantwell !n ask$ ,anne to ?9k ( a way %e c\ld reply to h] "m's nice criticism1 )\t feel+ bad ab\t h]self1 )\t gett+ hook$4 ,,anne3 ,well1 "o way y've taught me w\ld be to use humor3 ,i c\ld say to h]1 ,mom1 anytime y'd l to come ov] to d ! di%es1 x w\ld be f9e ) me4 ,& !n laugh4 ,,dr4 ,c43 ,t's a good approa*4 ,b y don't want to be (f5sive2 y don't want to laugh mock+ly4 ,h[ y d ?is is important4 ,y want to set a good-natur$ feel+4 ,humor c be v useful to (fset ! /+ ( criticism4 ,c y ?9k ( a diff]5t way to reply to y\r "m1 9 addition to humor8 ,,anne3 ,well1 let's see4444 ,yes1 well1 ,i c\ld g ) h] sugge/ion & n int]pret :at %e says to me z criticism at all4 ,i c\ld say1 ,mom1 ?anks = ! idea4 ,maybe ,i'll d t4 ,,dr4 ,c43 ,s\nds v good4 ,t's ano!r way4 ,! m alt]natives y c prep>e y\rself ) ahead ( "t1 ! less likely %e w hook y1 leav+ y ) no?+ to say & simply feel+ bad4 ,w\ld y try to ?9k ( "o m alt]native8 ,:at o!r tack c\ld y take8 ,,anne3 7,aft] a mom5t ( sil5ce47 ,i c't ?9k ( ano!r4 ,,dr4 ,c43 ,h[ ab\t tell+ y\r "m h[ y actually feel :5 %e criticizes y8 ,h[ d y feel8 ,,anne3 ,well1 ,i wi% %e'd say "s positive ?+s in/ead1 at lea/ sometimes4 ,t w\ld be nice4 ,,dr4 ,c43 ,great4 ,h[ c\ld y tell h] t8 ,,anne3 ,well1 ,i c\ld say1 ,mom1 y "k1 y give me a lot ( sugge/ions4 ,"s are ,,ok1 n[ & !n1 b1 to be #ahb hone/1 ,i'd really l to he> "s praise sometimes4 ,d y ?9k y c\ld f9d "s ?+s to complim5t me on8 ,i don't want any false praise1 b ,i ne$ to he> "s enc\rag+ ?+s f p ,i love4 ,,dr4 ,c43 ,anne1 y're do+ v well3 444 ,humor1 re9t]pret+ s y don't feel criticiz$1 & talk+ ab\t criticism f a m deta*$ po9t ( view4 ,y're def9itely le>n+ h[ to cope ) criticism mu* bett]4 ,,applications ,,( ,,behavioral ,,psy*o!rapy ,des5sitization is normally us$ 9 ! context ( individual !rapy4 ,behavior modification & cognitive approa*es to behavior *ange are frequ5tly us$ 9 gr\ps4 ,p ) problems 9 common--smok+1 obesity1 phobias1 etc4--are sometimes gr\p$ toge!r4 ,(t51 h[ev]1 a mixture 9 gr\ps is desirable4 ,= example1 x is frequ5tly helpful = %y p to be "p ( a gr\p 9 :i* !y may wat* o!rs :o c model m ass]tive ways ( act+4 7,= m ab\t gr\p !rapy1 see ,*apt] #ac47 ,behavioral approa*es to !rapy mu/ be tailor$ to ! individuality ( ea* cli5t2 :atev] goals are e/abli%$ h to be 9 accord ) ! cli5t's own desires4 ,behavioral psy*o!rapy presupposes t cli5ts w practice in/ructions & new behaviors betwe5 sessions & t !y c ma9ta9 an adequate level ( motivation1 bo? :ile 9 treatm5t & aft] treatm5t ends1 s t new habits ( behav+ or ?9k+ c become effective & reliable p>ts ( _! own p]sonalities4 ,9 g5]al1 behavioral approa*es to !rapy h be5 less effective 9 treat+ panic attacks1 *ronic depression1 sub/ance abuse 7smok+1 = example1 is "o ( ! habits mo/ resi/ant to =mal !rapy71 & psy*osis4 ,,c\nt]-,,condition+ ,?is approa*1 :i* includes des5sitization1 ass]tiv5ess tra9+1 & sex !rapy1 has be5 us$ effectively 9 treat+ ^! problems3 99 phobias 99 psy*osomatic compla9ts #ahc 99 sex1 m>riage1 & family problems 99 passivity & %yness 99 p]sonality trait problems3 lonely1 anxi\s1 ho/ile1 or ov]be>+ individuals ,,behavior ,,modification ,?is approa* has be5 us$ successfully 9 connection ) ^! problems3 99 sexually deviant behavior 99 *ildr5's problems1 s*ool discipl9e1 academic p]=mance1 & juv5ile del9qu5cy 99 problems ( ! m5tally ret>d$ & ( psy*otically regress$ individuals 99 "s in/ances ( obesity1 alcoholism1 & smok+ 99 s*izophr5ia 99 /utt]+ ,,cognitive ,,approa*es ,,to ,,behavior ,,*ange ,^! approa*es h1 = example1 be5 us$ to treat su* problems z3 99 anxiety & depression 99 adju/m5t problems 99 m>ital & sexual difficulties 99 psy*osomatic problems ,! popul> conception ( behavioral !rapi/s is t !y t5d to be coldly sci5tific & me*anical4 ,yet a numb] ( /udies %[ t !y are incl9$ to be w>m individuals :o %[ positive reg>d = _! cli5ts4 ,9 g5]al !y t5d to be empa!tic & self-congru5t4 ,^! qualities are v mu* ne$$ if we z cli5ts are to feel enc\rag$ to face "o ( ! mo/ difficult *all5ges life c pose = u3 to *ange ourselves4 #ahd #ac ,,gr\p ,,!rapy ,especially well-suit$ to p :o are out]-direct$ b lonely1 :o want to develop _! int]p]sonal skills1 & :o w\ld l to le>n ab\t !mselves f ! p]ceptions ( o!rs4 ,gr\p !rapy is anci5t4 ,= z long z m5 h ga!r$ toge!r to %>e _! exp]i5ces1 ?\ghts1 & feel+s & to give "o ano!r com=t1 gr\p !rapy has exi/$4 ,z an approa* to mod]n psy*o!rapy1 h[ev]1 x 0 9 its infancy fifty ye>s ago4 ,no s+le great m9d /&s beh9d gr\p !rapy2 x has be5 & cont9ues to be innovative1 flexible1 & free f ties to any p>ticul> or?odox s*ool ( ?\ght4 ,cli5ts :o are attract$ to gr\p !rapy & :o (t5 b5efit f gr\p exp]i5ce t5d to h ^! *>act]i/ics3 99 ,!y are passive 9 _! int]actions ) o!rs4 ,!y are m com=table be+ told :at to d ?an fac+ ! ne$ to decide = !mselves4 99 ,!y are (t5 lonely or socially isolat$4 ,individual #ahe !rapy1 ) its "o-to-"o relation%ip betwe5 !rapi/ & cli5t1 does n enc\rage "s cli5ts en\gh = !m to feel l memb]s ( humanity4 ,!y t5d to feel sorry = !mselves :ile 9 individual !rapy or to judge !mselves h>%ly = _! ne$ = help4 ,be+ ) o!r cli5ts 9 a gr\p situation answ]s _! ne$s bett]4 99 ,!y are out]-direct$ p3 :at o!rs ?9k ( !m is crucial to h[ !y ?9k ab\t !mselves4 ,inn]-direct$ individuals are likely to feel m int]e/$ 9 & com=table ) individual !rapy4 ,= p :o are relatively passive1 lonely1 yet out]-direct$1 gr\p !rapy has "s di/9ct advantages3 99 ,x gives !m a place )9 a gr\p ( p--!y are no long] alone4 99 ,x gives !m opportunities to express !mselves freely1 confront o!r p1 & say ?+s t !y o!rwise might n be able to express1 ?anks to ! close & confid5tial environm5t ( ! gr\p4 99 ,!y c he> h[ a v>iety ( o!r p p]ceive !m4 ,!y are n limit$ to ! obs]vations1 ideas1 & recomm5dations ( a s+le !rapi/4 99 ,!y (t5 feel m at ease 9 a gr\p4 ,!y feel less fe> or intimidation 9 ! pres5ce ( ! au?ority figure ! !rapi/ repres5ts4 99 ,!y may b5efit f ! exp]i5ces ( o!r gr\p memb]s :o h simil> problems or :o h v diff]5t k9ds ( difficulties4 ,kn[+ t !y are n tr\bl$ m9orities ( "o c be a com=t2 kn[+ t o!r p h problems 9 areas :]e !y don't c be reassur+4 ,9 g5]al1 gr\p !rapy c give y insight provid$ by ! ?\ghts & p]ceptions ( o!rs2 x c help y develop social ties if y feel isolat$2 & x c (f] gr\p support if y ne$ emotional bol/]+ 9 ord] to cope ) difficult situations1 und]take decisions t may fright5 y1 & face m calmly & confid5tly ! _m *all5ges life c pres5t4 ,b x c also help y deal ) m specific problems1 su* z fac+ an especially /ressful situation--! dea? ( #ahf someone v close to y1 divorce or sep>ation1 s]i\s illness1 unemploym5t1 drug addiction1 or alcoholism4 ,or p]haps y h problems relat+ to o!rs1 su* z hav+ a hi/ory ( be+ fir$ f job aft] job despite y\r ef=ts to hold !m4 ,= t matt]1 gr\p !rapy c ev5 (f] in=mation ab\t job opportunities1 h[ to develop occupational skills1 h[ to apply = a job1 & h[ to keep a position y hold4 ,"s psy*ologi/s h comm5t$ t ! popul>ity & ! ne$ = ! k9d ( exp]i5ce t gr\p !rapy (f]s are due to ! decl9e ( community life & to ! virtual disappe>ance ( ext5d$ families liv+ physically & emotionally close to "o ano!r4 ,gr\p !rapy is (f]$ 9 private practice1 9 hospitals1 & 9 halfway h\ses2 9 psy*iatric & c\nsel+ c5t]s1 9 cl9ics & hospital w>ds = pati5ts ) diabetes1 ,,aids1 epilepsy1 ar?ritis1 he>t conditions1 p>alysis1 bl9dness2 9 prisons & juv5ile det5tion c5t]s2 & 9 s*ools1 = /ud5ts ) behavior problems & truancy4 ,gr\p !rapy is (t5 us$ = m>riage1 family1 & *ild-guidance c\nsel+ & to help families 9 :i* a memb] is physically or emotionally disabl$4 ,gr\p !rapy is us$ by *ur*es = family guidance & = spiritual c\nsel+4 ,x is us$ 9 virtually any area :]e p %>e problems3 victims ( crime & physical abuse1 =m] pati5ts1 ! ag$1 *ildr5 ( ! ag$1 ^? :o are discrim9at$ aga9/--! li/ goes on4 ,s1 gr\p !rapy cuts across virtually ! :ole range ( human problems4 ,because x is us$ 9 s _m areas1 x is impossible to def9e x z a s+le approa*--_m di/9ct approa*es actually may be involv$4 ,_m ( ! approa*es to psy*o!rapy we h already look$ at are us$ 9 gr\ps4 ,!re are psy*oanalytically ori5t$ gr\ps1 ,adl]ian gr\ps1 ,ge/alt gr\ps1 gr\ps t use behavior modification1 & o!rs4 ,p]haps ! mo/ useful way to und]/& gr\p !rapy is to lik5 x to education4 ,_m sorts ( ?+s c be taught1 & _m c be le>n$4 ,gr\p !rapy may be und]/ood mo/ cle>ly 9 relation to :at k9ds ( le>n+ & tea*+ really g on 9 x4 ,s9ce gr\p approa*es to problem solv+ include _m applications beyond our scope "h--9 indu/ry1 religion1 s*ools1 etc4--we w look m closely at ! foll[+ =ms ( gr\p !rapy t are us$ 9 ! context ( psy*o!rapy3 brief gr\p psy*o!rapy1 ,t-gr\ps1 #ahg human pot5tial gr\ps1 self-help gr\ps1 & ! use ( specializ$ approa*es to psy*o!rapy 9 a gr\p sett+4 7,m>riage & family !rapy1 :i* are special =ms ( gr\p !rapy1 are ( int]e/ to a l>ge numb] ( p1 s !y are discuss$ sep>ately1 9 ,*apt] #ad47 ,,brief ,,gr\p ,,psy*o!rapy ,also kn[n z %ort-t]m enc\nt] gr\ps1 brief gr\p psy*o!rapy is int5d$ = p :o face life crises1 :o are motivat$ to *ange1 & :o are comp>atively free ( individual emotional disord]s4 ,normally1 !re are ab\t t5 sessions4 ,p :o f9d %ort-t]m gr\p !rapy useful g5]ally h well-def9$ problems to solve4 ,_! exp]i5ce 9 gr\p !rapy enc\rages !m to become involv$ 9 new activities1 jo9 clubs1 p]haps d volunte] "w aft] be+ rec5tly wid[$1 divorc$1 or sep>at$2 to take specific /eps to f9d employm5t2 or to practice new ways ( behav+--to become m ass]tive1 to implem5t a weight-loss plan1 to return to s*ool aft] rais+ a family1 or to *ange c>e]s4 ,t-,,gr\ps ,tra9+ gr\ps 7 an outgr[? ( ! ,national ,tra9+ ,laboratories1 an organization =m$ 9 #aidg by social psy*ologi/s :o 7 int]e/$ 9 improv+ education4 ,t-gr\ps 7 made up ( normally adju/$ p :o 7 int]e/$ 9 improv+ _! communication skills s !y c\ld become m compet5t 9 difficult int]p]sonal situations4 ,t-gr\ps gradually wid5$ _! focus & became ! basis = ! practical ori5tation ( _m !rapy gr\ps today4 ,cli5ts :o feel isolat$ or ali5at$1 f9d x h>d to relate to o!rs1 lack a s5se ( mean+ & direction1 & d n h /rong self-discipl9e (t5 are attract$ to ,t-gr\ps4 ,,human ,,pot5tial ,,gr\ps ,^! gr\ps h probably done ! mo/ to give gr\p !rapy its popul> image4 ,gr[? c5t]s are usually rural retreats :]e psy*ological gr[? ( p>ticipants is enc\rag$4 ,visits la/ f a week5d to sev]al weeks4 ,! fir/ #ahh c5t] 0 call$ ,lifewynn1 organiz$ 9 ! #aibjs at a summ] camp 9 ,new ,york's ,adirondack ,m\nta9s4 ,! be/-kn[n gr[? c5t] is ! ,esal5 ,in/itute 9 ,big ,sur1 ,cali=nia1 =m$ 9 #aifb by ,mi*ael ,murphy4 ,its program comb9es ,ge/alt !rapy ) ,ea/]n m$itation 7see ,*apt] #ae74 ,o!r simil> gr[? c5t]s h sprung up across ! c\ntry4 ,9 addition to ^!1 ! e/ 7,erh>d ,sem9>s ,tra9+7 organization has attract$ a good deal ( public att5tion & controv]sy4 ,! e/ approa* is eclectic1 comb9+ ,ea/]n ?\ght1 ,ge/alt !rapy1 transactional analysis1 psy*oanalysis1 ,jungian philosophy1 positive ?9k+1 m$itation1 & o!r approa*es4 ,"s e/ lead]s h be5 describ$ z *>ismatic1 proselytiz+ p]sonalities :o claim to be able to lead p>ticipants to salvation4 ,,self-,,help ,,gr\ps ,!re are self-help gr\ps to aid y ) _m diff]5t k9ds ( problems4 ,!y provide gr\p moral support = memb]s ) %>$ problems4 ,!y are n int5d$ to br+ ab\t deep-seat$ p]sonality *ange4 ,alcoholics ,anonym\s 7,,aa71 f\nd$ 9 #aicd1 probably is ! mo/ well-kn[n self-help organization4 ,recov]y1 ,inc41 also kn[n z ! ,association ( ,n]v\s & ,=m] ,m5tal ,pati5ts1 0 =m$ 9 #aicf by psy*iatri/ ,abraham ,a4 ,l[4 ,meet+s focus on memb]s' consci\s control ( symptoms2 ,recov]y1 ,inc41 frequ5tly enc\rages memb]s to become involv$ 9 volunte] social "w4 ,!re are _m o!r self-help organizations--= ! h&icapp$1 wid[s1 batt]$ wives1 diabetics1 victims ( ,,aids1 hemophiliacs1 homosexuals1 drug addicts1 & o!rs4 7,= fur!r in=mation see ,app5dix ,a3 ,ag5cies & ,organizations ,t ,c ,help47 ,,psy*o!rapy ,,9 ,a ,,gr\p ,,sett+ ,mo/ ( ! approa*es to psy*o!rapy t we h discuss$ provide treatm5t 9 ! =m ( gr\p !rapy 9 addition to individual !rapy4 ,gr\p !rapy is frequ5tly (f]$1 = example1 by psy*oanaly/s1 cli5t-c5t]$ !rapi/s1 ,ge/alt !rapi/s1 transactional analy/s1 rational-emotive !rapi/s & g5]al cognitive !rapi/s1 exi/5tial-humani/ic #ahi !rapi/s1 reality !rapi/s1 ,adl]ian psy*o!rapi/s1 emotional flood+ !rapi/s1 & behavior modification !rapi/s4 ,9 ! rema9d] ( ?is *apt]1 we w discuss h[ gr\p !rapy is h&l$ by ! ma9 psy*o!rapies4 ,,:at ,,gr\p ,,!rapy ,,is ,,l ,al?\gh y\r exp]i5ce ) gr\p !rapy w v>y dep5d+ on :i* s*ool ( !rapy y h *os51 y w f9d "s common elem5ts reg>dless ( ! approa*4 ,initially1 !re is likely to be a p]iod ( gr\p confusion1 awkw>d p]iods ( sil5ce1 "s polite sup]ficial conv]sation1 & (t5 a fru/rat+ lack ( ov]all organization & cont9uity4 ,diff]5t gr\p memb]s w speak up1 & :at !y say may h absolutely no?+ to d ) :at ! previ\s speak] has said2 p are wait+ = ! *ance to talk ab\t !mselves & t5d to conc5trate s mu* on :at !y are prep>+ to say t !y don't pay att5tion to :at o!rs h be5 say+4 ,gradually1 a m organiz$ /yle ( int]act+ comes into be+ ?r\gh ! directive ef=ts ( ! !rapi/ or z a result ( g5]al gr\p fru/ration ov] ! lack ( coh]5ce4 ,at ! same "t1 gr\p memb]s w beg9 to feel m at ease ) "o ano!r & w 9 "t beg9 to lift _! public masks & reveal m ( _! private selves--_! (t5 h>d-to-admit feel+s ( lonel9ess1 pa91 anxiety1 depression1 etc4--& to express _! p]sonal ne$s4 ,frequ5tly1 ! fir/ /eps 9 ! direction ( express+ private feel+s w involve attacks on ! !rapi/ = n /ructur+ ! gr\p's int]actions m or attacks on "o memb] = monopoliz+ gr\p sessions4 ,exp]i5c$ gr\p !rapi/s realize t ^! common negative attacks are und]/&able te/s ( ! tru/wor?9ess & ! safety ( ! gr\p z a place to express p]sonal feel+s4 ,if an atmosph]e ( acceptance is e/abli%$1 & ^! initial compla9ts are all[$ to occur )\t cata/rophe1 "s gr\p memb]s w usually !n beg9 to op5 up1 to reveal "s deep] feel+s4 ,"o memb] may beg9 to talk ab\t h] unhappy m>riage1 a man ab\t 8 gambl+ obsession1 ano!r ab\t 8 lonel9ess s9ce 8 wife di$4 ,at ab\t ?is "t x is common = gr\p memb]s to beg9 to #aij tell "o ano!r h[ !y feel ab\t ea* o!r1 h[ !y see "o ano!r4 ,"s ( ^! comm5ts w be positive1 "s negative4 ,"h are "s examples3 ,y h a really nice smile4 ,y rem9d me ( my fa!r1 all ^! %\lds1 oughts1 & rules6 ,y nev] say mu*1 s ,i feel y're j sitt+ !re judg+ u4 ,y make me n]v\s1 bit+ y\r nails all ! "t4 ,e "t y say some?+1 y put y\rself or somebody else d[n4 ,z ?is process cont9ues1 "o or two gr\p memb]s w beg9 to take an int]e/ 9 ! p]sonal problems ( "s ( ! o!rs & express a desire to help4 ,!y w ask que/ions = m in=mation1 express sympa?y or empa?y1 & beg9 to (f] sugge/ions4 ,x is at ?is po9t t ! process ( gr\p int]action beg9s to acquire a focus on heal+ & problem solv+4 ,frequ5tly1 ^! expressions ( desire to help "o memb] w enc\rage him or h] = ! fir/ "t to beg9 to accept ! k9d ( p]son he or %e has be51 to realize t ,i h be5 too h>d on myself because ,i'm s damn$ p]fectioni/ic1 ,i am a controll]2 ,i want o!r p to d ?+s my way1 or ,i live 9 a suit ( armor2 ,i'm j afraid ( o!r p4 ,z memb]s ( ! gr\p come to "k "o ano!r z real p]sonalities1 !y t5d to become impati5t :5ev] anyone tries to put on 8 public mask aga94 ,! gr\p dem&s & expects memb]s to be hone/ ab\t !mselves4 ,feel+s c run hot :5ev] ,fr$ tries to make ,alice accept 8 sugge/ions because he kn[s :at %e really ne$s4 ,gr\p memb]s c %[ quick impati5ce ) ,judy :5ev] %e tries to p]suade h]self1 ev5 ?\gh h] husb& has sev]ely beat5 h] sev]al times1 t h] m>riage is really ,,ok4 ,gr\p memb]s quickly ga9 a good deal ( in=mation ab\t h[ o!rs see !m & feel ab\t !m4 ,z a result ( an implicit commitm5t to hone/y1 "s memb]s' ways ( behav+ gradually *ange3 a r\gh tone ( voice becomes less abrasive & calm]2 (f5sive ge/ures & judg+ looks #aia disappe>2 self-c5t]$ness gives way to a c]ta9 am\nt ( sympa?y & int]e/ 9 o!r p4 ,"s ( ! values ( gr\p !rapy are s5sitively express$ 9 ?is passage f a lett] writt5 by a cli5t to 8 gr\p3 ,i h come to ! conclusion t my exp]i5ces ) y h pr(\ndly affect$ me4 ,i am truly grateful4 ,?is is diff]5t f p]sonal !rapy4 ,none ( y _h to c>e ab\t me4 ,none ( y _h to seek me out & let me "k ( ?+s y ?\ght w\ld help me4 ,yet y did1 & z a result x has f> m mean+ ?an any?+ ,i h s f> exp]i5c$4 ,:5 ,i feel ! ne$ to hold back & n live spontane\sly = :atev] reasons1 ,i rememb] t twelve p]sons 444 said to let g & 444 be myself & ( all ! unbelievable ?+s !y ev5 lov$ me4444 ,?is has giv5 me ! c\rage to come out ( myself _m times s9ce !n4444#a #a ,quot$ 9 ,c>l ,r4 ,rog]s1 ,c>l ,rog]s on ,enc\nt] ,gr\ps 7,new ,york3 ,h>p] & ,r[1 #aigj71 p4 #cc4 ,,! ,,risks ,un=tunately1 l _m heal+ processes1 gr\p !rapy is n = ev]yone4 ,!re are recogniz$ risks ( ent]+ gr\p !rapy4 ,:5 memb]s leave ! intimacy ( _! gr\p & return to ! real _w1 !y may feel disappo9t$ & disc\rag$4 ,_! exp]i5ce has giv5 !m ! opportunity to disp5se ) social masks1 to become m au!ntic1 to see ! lies & pret5ses ( o!rs m cle>ly4 ,b ! va/ majority ( p outside ! gr\p h n le>n$ ^! ?+s & d live beh9d masks !y are n ev5 consci\s (4 ,:5 y ga9 f a le>n+ exp]i5ce a p]spective y c %>e ) comp>atively few p1 y're likely to feel discont5t$ & ali5at$4 ,y %\ld also be aw>e t "s ( ! *anges t occur 9 gr\p !rapy simply may n la/ v long aft] ! gr\p /ops meet+ because ! emotional & moral support (f]$ by ! gr\p are no long] !re4 ,or1 gr\p !rapy may make y aw>e = ! fir/ "t ( p]sonal problems y _h ignor$ or evad$1 leav+ y hang+ :5 ! gr\p t]m9ates4 ,s gr\p !rapy may br+ ab\t a ne$ to solve problems t1 be=e ! gr\p exp]i5ce1 y didn't ev5 #aib "k y _h4 ,^! problems may !n motivate y to ent] individual !rapy4 ,f9ally1 if y ent] gr\p !rapy b y\r sp\se does n1 y\r exp]i5ce c\ld br+ m>ital t5sions into ! op51 leav+ y\r sp\se at a disadvantage4 ,y\r sp\se1 :o is unfamili> ) :at transpir$ dur+ y\r gr\p sessions1 may react def5sively & )\t empa?y to y\r desire to talk ab\t y\r feel+s4 ,,gr\p ,,te*niques ,! te*niques discuss$ bel[ are commonly us$ 9 gr\p !rapy4 ,cont5t ,analysis ,a memb] ( ! gr\p describes a problem he or %e is hav+1 & ! !rapi/ & o!r memb]s make problem-solv+ sugge/ions4 ,_! focus may be on :y ! p]son does n want to solve ! problem or on h[ ! p]son br\ght ! problem on & ma9ta9s x4 ,gr\p ,process ,aft] a s]ies ( int]actions1 comm5ts1 sugge/ions & p]sonal obs]vations by gr\p memb]s1 ! !rapi/ w ask ! gr\p to /& back & look at ! patt]n ( _! communication4 ,! gr\p may become aw>e ( ! way "o memb] is consi/5tly ov]look$ & is n giv5 a fair %>e ( att5tion because ( %yness or because ano!r m =ceful memb] dom9ates ! gr\p's att5tion4 ,models ,"o memb] c "w on p]sonal problems 9 gr\p !rapy by not+ h[ ano!r memb] goes ab\t h&l+ a simil> problem & !n try+ to le>n f t example4 ,analysis ( ,nonv]bals ,! gr\p !rapi/ & memb]s ( ! gr\p c (t5 help make an individual bett] aw>e ( h[ 8 or h] behavior has contribut$ to p]sonal problems4 ,= example1 ,jim t5ds to be %y1 makes poor eye contact ) p1 has bad po/ure1 & speaks indi/9ctly because he has a habit ( cov]+ 8 m\? #aic ) 8 f+]s4 ,! impression he makes on p is weak4 ,by help+ him pay att5tion to ^! nonv]bal habits1 gr\p memb]s c enc\rage ,jim to *ange s he w be m successful1 = example1 at job int]views & g5]ally feel m confid5t4 ,,applications ,,( ,,gr\p ,,!rapy ,z we h se51 gr\p !rapy is mo/ helpful to p ) ^! *>act]i/ics3 99 ,!y are lonely1 socially isolat$1 or passive4 99 ,_! s5se ( wor? dep5ds greatly on :at o!rs ?9k ( !m4 99 ,!y w\ld l to improve _! int]p]sonal skills4 99 ,!y may be drawn to gr\p !rapy = ! practical reason t x t5ds to be less exp5sive ?an individual !rapy4 ,gr\p !rapy has ! di/9ct advantage ( provid+ cli5ts ) multiple po9ts ( view2 !y receive fe$back f ! !rapi/ z well z f o!r memb]s ( ! gr\p4 ,gr\p !rapy is pot5tially useful = a v wide range ( problems4 ,?is is evid5t f ! fact t mo/ approa*es to psy*o!rapy (f] !rapy 9 a gr\p sett+4 ,gr\p !rapy is g5]ally n ! treatm5t ( *oice = ^! individuals3 99 p]sons lack+ communication skills 99 ^? :o lack ! motivation to att5d gr\p sessions regul>ly or :o refuse to keep in=mation ab\t o!r gr\p memb]s confid5tial outside ( ! gr\p 99 p :o are sev]ely di/urb$ 99 individuals :o are intellectually impair$ 99 ^? suff]+ f *ronic depression 99 psy*opa?ic or sociopa?ic adolesc5ts 7:o d n h a s5se ( social consci5ce7 ,gr\p !rapy1 z we h not$1 also appeals less to inn]-direct$ individuals & is !re=e less likely to be helpful to !m4 #aid #ad ,,m>riage ,,& ,,family ,,!rapy ,= c\ples & families ) problems ( communication1 /ra91 & conflict1 & = individuals ^: difficulties are be/ resolv$ ) ! p>ticipation ( o!r family memb]s4 ,! family is ! basic s\rce ( heal? or sickness4 ,v9c5t ,d4 ,foley1 ,curr5t ,psy*o!rapies ,dur+ ! la/ =ty ye>s !re has be5 a gradual %ift away f an emphasis on individual !rapy to a belief t _m emotional difficulties p exp]i5ce h _! roots--& (t51 also _! solutions--9 _! m>riages or families4 ,z ?is %ift 9 emphasis grew1 _m !rapi/s saw t m>riage & family relation%ips make up units1 or sy/ems1 ea* ) a p]sonality ( its own4 ,memb]s ( a family ga9 _! id5tities f _! roles 9 ! family sy/em4 ,?is sy/ems view made x possible = !rapi/s to und]/& families & m>riages m cle>ly z int]dep5d5t1 int]lock+1 function+ :oles4 #aie ,m>riage & family !rapy treats emotional disord]s 9 t]ms ( ! int]dep5d5t relation%ips among memb]s4 ,! m>riage or family sy/em is ?\ght ( z a unit ) prop]ties t rea* beyond ! sum ( ! p]sonal qualities ( ! individuals :o make x up4 ,usually1 "o p]son 9 a family or m>riage is m tr\bl$2 8 or h] symptoms are m pron\nc$4 ,! husb& t5ds to feel 8 wife has ! problem1 or vice v]sa4 ,"m & fa!r feel t little ,ri*>d is ! problem4 ,h[ev]1 !rapi/s believe t ! problems exp]i5c$ & express$ by ! sick p]son are really signs t some?+ is wrong ) ! :ole sy/em4 ,a he>t problem is frequ5tly "p ( a l>g] problem1 su* z poor diet or excessive /ress1 & ! same is true = c\ples or families4 ,"o p]son's di/ress tells ! !rapi/ t1 (t51 some?+ is tr\bl+ bo? husb& & wife or all ! memb]s ( a family4 ,?is int]dep5d5ce betwe5 p>tn]s ( a m>riage or memb]s ( a family sy/em frequ5tly leads to a complex situation 9 :i* emotional difficulties are contagi\s1 "o p]son's improvem5t is connect$ ) ano!r's gett+ worse1 or treat+ "o p]son sep>ately draws ! memb]s ( a relation%ip ap>t4 ,"o ( ! v difficult problems tr\bl$ c\ples or families face is t emotional di/urbance c (t5 spread4 ,repeat$ly1 !rapi/s obs]ve t !re is a k9d ( subtle transmission f "o g5]ation to ! next ( inn] conflicts & difficulties 9 cop+ ) life4 ,& beyond ?is1 !re are intimate connections betwe5 ! emotional makeup & emotional balance ( m>ri$ p>tn]s or family memb]s4 ,= example1 x is all too common = ! p>tn] ( a *ronically depress$ p]son also to fall into a s]i\s depression4 ,m>riage & family !rapi/s are !re=e incl9$ to see ! emotional di/urbance ( "o memb] 9 t]ms ( a tr\bl$1 ineffective patt]n ( int]action4 ,because ( _! close ties1 sometimes "o p]son's behavior1 attitudes1 or feel+s get bett] :ile ano!r family memb] develops new symptoms or problems4 ,we w look at a real example ( ?is 9 a mom5t4 ,m>riage & family !rapi/s h notic$ t1 :5 "o p]son 9 a m>riage or family is treat$ sep>ately1 ! family memb]s frequ5tly are drawn ap>t in/ead ( br\ght clos] #aif toge!r4 ,!re=e1 !rapi/s g5]ally feel x is ess5tial to see husb& & wife toge!r or to involve bo? p>5ts & *ildr5 9 !rapy4 ,! purpose ( m>riage or family !rapy is n only to resolve exi/+ problems b also to help cli5ts cultivate a new way ( communicat+ & int]act+ toge!r4 ,m>riage !rapy & family !rapy ( c\rse seek to relieve emotional di/ress by help+ to r$uce or end conflicts & to less5 anxiety1 fru/ration1 ang]1 or res5tm5ts4 ,b beyond ^!1 m>riage & family !rapi/s try to %[ cli5ts h[ to complem5t "o ano!r's p]sonal ne$s4 ,!y also attempt to /r5g!n bonds betwe5 !m s t !y are able to face crises & emotional upsets ) great] /r5g?1 balance1 & c\rage4 ,& !y try to r$irect cli5ts' values 9 a way t w support ! p]sonal gr[? ( ea* p]son4 ,h[ long m>riage or family !rapy w take dep5ds prim>ily on ! goals ( ! c\ple or family4 ,"h are "s e/imates3 99 to r$uce t5sions3 p]haps six sessions 99 to r$uce symptoms su* z emotional di/ress or behavioral problems3 t5 to fifte5 sessions 99 to improve communication habits3 tw5ty-five to ?irty sessions ov] six to eight mon?s 99 to re/ructure relation%ips s t memb]s ( ! family sy/em w h m indep5d5ce & w cultivate an aw>5ess t !y d h sep>ate id5tities3 =ty sessions or m ,,:at ,,m>riage ,,& ,,family ,,!rapies ,,are ,,l ,m>riage !rapy & family !rapy are di/9ct f gr\p !rapy 9 two important ways4 ,fir/1 unlike 9 gr\p !rapy ! cli5ts 9 m>riage or family !rapy h a %>$ hi/ory &1 if !rapy is successful1 w (t5 be able to enjoy a %>$ future4 ,second1 9 m>riage & family !rapy1 ! !rapi/ is m active & directive ?an 9 gr\p !rapy4 ,any *anges made by memb]s ( a gr\p come ab\t because ( int]actions among ! gr\p memb]s2 a gr\p !rapi/ acts z a mod]ator or facilitator1 :ile ! role ( a m>riage or family !rapi/ resembles t ( a tea*]4 #aig ,m>riage & family !rapy focuses on pres5t int]actions betwe5 husb& & wife or among family memb]s4 ,x is n t ! pa/ is judg$ to be unimportant1 b x is n g5]ally useful to pay a great deal ( att5tion to :at has already happ5$4 ,:at causes problems n[ are ! curr5t patt]ns & habits ( int]action 9 ! family or m>riage4 ,a wife may h be5 dr9k+ = fifte5 ye>s because h] "m und]m9$ h] s5se ( self-confid5ce1 b ! fact is t %e no long] lives ) h] "m4 ,h[ev]1 %e did *oose to live ) a man :o cont9u$ h] "m's patt]n ( und]m9+ abuse4 ,a m>riage !rapi/ w focus on pres5t difficulties &1 by do+ ?is1 may be able to help h] resolve h] dr9k+ problem by improv+ a tr\bl$ relation%ip ) h] husb&4 ,jay ,haley 7#aibc-bjjg71 a lead+ m>riage & family !rapi/1 has express$ ! belief t conc5trat+ on feel+s & ?9k+ w n lead to *ange1 t empa?y on ! "p ( ! !rapi/ does n correct problems1 & t insight (t5 j provides an excuse = intellectual rationalization & game-play+4#a #a ,jay ,haley1 ,m>riage ,!rapy1 9 ,g]ald ,d4 ,erickson & ,t]rance ,p4 ,hogan1 eds41 ,family ,!rapy3 ,an ,introduction to ,!ory & ,te*nique 7,mont]ey1 ,,ca3 ,brooks_/,cole1 #aigb71 pp4 #ahj-baj4 ,because ! patt]ns ( behavior ( a tr\bl$ c\ple or family t5d to be v rigid1 !rapi/s h f\nd t /rongly directive te*niques are mo/ effective4 ,_! focus is on develop+ int]v5tions--or !rapeutic /rategies--t w h a real impact on ! complex patt]ns ( int]action t h come to p>alyze a c\ple or a family4 ,:at seems to help 9 m>riage & family !rapy is +5uity on ! "p ( ! !rapi/ t w give him or h] p[] or control ov] a situation t is out ( control4 ,"o way to d ?is is to =ce cli5ts into a p>adoxical situation4 ,= example1 ! !rapi/ may prescribe t a c\ple or memb]s ( a family cont9ue _! pres5t unsatisfy+ behavior4 ,z a result1 !y may 7& v likely w7 rebel s t desir$ *ange comes ab\t4#b #b ,z we h se51 logo!rapy & ,adl]ian !rapy bo? make use ( ?is te*nique1 z d family !rapi/s1 z we w see lat] on4 ,all family !rapy is m>riage !rapy to a c]ta9 ext5t4 ,& s1 suppose we fir/ look m closely at :at m>riage !rapy is l4 #aih ,,m>riage ,,!rapy ,m>riage !rapy is g5]ally advisable#c :5 ! husb& or wife has s\ght help 9 individual c\nsel+ b ?is has n be5 helpful4 ,sometimes ! m>ital relation%ip itself inhibits1 or ev5 und]m9es1 ! improvem5t ( ! mo/ tr\bl$ p]son4 ,= example1 individual !rapy did no?+ to help "o woman :o 0 suff]+ f sev]e *ronic anxiety4 ,:5 h] husb& 0 ask$ to p>ticipate 9 treatm5t1 x 0 f\nd t he abus$ 8 wife cont9u\sly b subtly4 ,:5ev] %e spoke1 he w\ld criticize h] views & indirectly slight h] wor?2 :5 he lo/ some?+1 he w\ld (t5 accuse h] ( misplac+ x4 ,! problem %e _h come = help ) turn$ out to be m>ital r ?an individual4 #c ,see ,jay ,haley1 ,m>riage ,!rapy1 pp4 #ahj-baj4 ,if y are unable or unwill+ to communicate op5ly & adequately ) a !rapi/1 m>riage !rapy may enc\rage y\r sp\se to become m involv$ 9 ! process ( !rapy4 ,(t51 hav+ ! o!r m>ital p>tn] pres5t w /imulate an o!rwise sil5t cli5t to express himself or h]self1 especially to correct :at ! o!r p>tn] has to say6 ,if y sudd5ly become sev]ely tr\bl$ at ! "t ( a m>ital conflict1 m>riage !rapy may be useful4 ,a sp\se :o falls into a deep depression imm$iately aft] a qu>rel may be tr\bl$ 9 a way t m>riage !rapy c treat4 ,f9ally1 m>riage !rapy is ( c\rse ess5tial if a husb& & wife are 9 conflict & s]i\s di/ress & _c resolve _! diff]5ces4 ,frequ5tly1 "o sp\se 7usually ! wife7 w want m>riage !rapy2 ! o!r w come1 b reluctantly4 ,h[ev]1 bo? (t5 w come1 because if "o is 9 di/ress ! o!r is affect$4 ,conflicts 9 m>riage frequ5tly come ab\t because ( disagreem5ts hav+ to d ) ! c\ple's rules = liv+ toge!r1 especially reg>d+ h[ ea* is to treat ! o!r4 ,:o sets ! rules is (t5 ano!r area ( conflict1 z are incompatible rules4 ,= example1 a wife insi/s t h] husb& /op be+ a mama's boy & demeans him = be+ dom9at$ by a woman2 yet x is %e :o seeks to dom9ate h] husb& by insi/+ t he be m dom9e]+4 ,9 m>riage !rapy 7& also 9 family !rapy71 !rapi/s #aii enc\nt] a great deal ( resi/ance to *ange on ! "p ( _! cli5ts4 7,alas1 s d all o!r !rapi/s67 ,a ma9 reason = resi/ance is t1 9 a m>ital relation%ip or family sy/em1 *ange 9 "o memb]'s feel+s & behavior w t5d to affect ano!r's1 (t5 9 unsuspect$ ways4 ,*ange di/urbs ! e/abli%$ balance ( _! sy/em1 a balance t does s]ve "s purposes4 ,jane ,d[l&1 = example1 w5t to see ,dr4 ,c>lton because ( h] husb&'s depression4 ,phil _h lo/ 8 job & n[ sp5t mo/ ( 8 "t at home1 feel+ sorry = himself & collect+ unemploym5t b5efits4 ,jane 0 easily upset & felt t]ribly insecure4 ,dr4 ,c>lton recomm5d$ t ,phil accompany ,jane to ! next session4 ,aft] see+ ,phil1 ,dr4 ,c>lton ref]r$ him to a psy*iatri/1 :o 0 able to treat ,phil's depression effectively 9 f\r mon?s' "t ) m$ication4 ,jane1 h[ev]1 cont9u$ to feel sev]ely 7& p]haps ev5 m7 anxi\s1 al?\gh ,phil's symptoms 7 n[ "u control & he 0 back at "w4 ,dr4 ,c>lton recomm5d$ m>riage !rapy to ,jane & ,phil4 ,!y saw ,dr4 ,c>lton once a week = ?ree mon?s4 ,x became cle> to ,dr4 ,c>lton1 & ev5tually cle> to ,jane1 t )\t realiz+ x %e _h us$ ,phil's depression z an excuse = h] own anxiety s t %e c\ld evade responsibility = h]self4 ,%e came to realize t %e _h be5 unable to resolve h] own conflict+ ne$s--:e!r to h *ildr5 9 spite ( ,phil's dis9t]e/ 9 *ildr5 or :e!r to commit h]self to develop+ a c>e]4 ,treat+ ,phil's depression l$ ,jane to become aw>e ( h] own problems4 ,! balance 9 _! relation%ip 0 *ang$ by !rapy3 ,jane f\nd out t ,phil's depression 0 really a problem t s]v$ a purpose = h]--)\t x1 %e ne$$ help = h]self4 ,because ( ! complex1 int]wov5 nature ( a m>ital relation%ip1 x is (t5 difficult to sep>ate ! problems ea* p>tn] may exp]i5ce4 ,"o p>tn]'s symptoms may mask ! o!r's problem4 ,or1 "o p]son's problem may be p]petuat$ by ! o!r's behavior1 int]f]+ ) ! resolution ( ! problem4 ,fur!r1 ea* p>tn] may enc\rage di/ress 9 ! o!r z a result ( diff]+ expectations conc]n+ rules ( liv+ toge!r & :o sets !m4 #bjj ,,family ,,!rapy ,9 family !rapy1 ! id5tifi$ pati5t is se5 z b a symptom1 & ! sy/em itself 7! family7 is view$ z ! cli5t4 ,v9c5t ,d4 ,foley1 ,curr5t ,psy*o!rapies ,v (t51 "o family memb] is label$ ! "o ) ! problem1 ! "o :o is sick4 ,:5 ! family decides to ent] !rapy1 x is usual = family memb]s to feel tr\bl$1 sc>$1 & confus$4 ,!y realize t some?+ is wrong1 b !y are unc]ta9 ab\t :at is amiss & don't "k :at to d4 ,! usual response to ?is p]plexity is to pu% ! id5tifi$ pati5t =w>d--usually a *ild :o is ! problem--& try to make him or h] ! focus ( treatm5t4 ,z ! memb]s ( ! family are int]view$1 individually & toge!r1 ! !rapi/ is able to assemble a coh]5t picture ( ! family1 its typical ways ( int]act+1 ! habitual1 automatic patt]ns ( response ( "o family memb] to ano!r1 ! family's values & beliefs4 ,:at "o memb] tries to hide ano!r (t5 w express4 ,! family !rapi/ has a difficult d\ble role1 z bo? obs]v] & p>ticipant4 ,he or %e ne$s to be able to notice :at ! /yles ( int]action ( individual family memb]s are & at ! same "t int]act ) memb]s ( ! family4 ,! !rapi/ tries to br+ ab\t mean+ful emotional int]*ange1 create an atmosph]e ( tru/ & rapport1 & r$uce ! feel+ t family memb]s are ?reat5$4 ,ov] "t1 ! !rapi/ seeks to %[ ! memb]s ( a family h[ !y t5d to int]relate inappropriately1 h[ _! own ineffective def5ses cause !m to hurt "o ano!r4 ,to d ?is1 ! !rapi/ has to be able to cut ?r\gh ! vici\s circles ( res5tm5t1 ang]1 blame1 fru/ration1 & intimidation t frequ5tly hold families 9 a dea? grip4 ,,! ,,!rapi/',s ,,functions ,9 bo? m>riage & family !rapy !rapi/s mu/3 99 e/abli% a s5se ( rapport & tru/+ communication betwe5 cli5ts & !mselves #bja 99 use ?is rapport to br+ out ! conflicts1 fru/rations1 & inadequate means ( communication t burd5 _! cli5ts 99 see ?r\gh d5ials1 rationalizations1 & excuses 99 pu% family memb]s to put out 9 ! op5 feel+s & pa9s !y h kept f "o ano!r 99 br+ to a halt ! family's t5d5cy to focus on "o p]son z a scapegoat1 ! problem 99 act 9 und]/&+1 calm1 & emotionally supportive ways & help supply ! emotional /ability t ! c\ple or family tempor>ily lacks 99 try to exemplify or p]sonify = cli5ts :at x is to be adult1 mature1 c>+1 & able to relate op5ly & )\t feel+ ?reat5$ ,,m>riage ,,& ,,family ,,!rapy ,,te*niques ,m>riage & family !rapi/s may use a v>iety ( te*niques to enc\rage _! cli5ts to *ange 9 con/ructive ways4 ,= example1 x is becom+ m common to videotape sessions s t c\ples & families may become m aw>e ( _! automatic1 self-de/ructive patt]ns ( int]action--:i* makes x easi] to *ange !m4 ,family !rapi/s also sometimes make home visits3 (t51 be+ 9 _! own famili> surr\nd+s w enc\rage family memb]s to let d[n _! def5ses & m cle>ly def9e ! problems t ne$ to be resolv$4 ,ano!r innovation t is becom+ m widespread is multifamily !rapy4 ,two or ?ree families p>ticipate toge!r 9 an especially modifi$ =m ( gr\p !rapy s t ea* family c see its own problems 9 cle>] p]spective & le>n by see+ m or less tr\bl$ int]actions among memb]s ( ano!r family4 ,te*niques drawn f behavior modification are frequ5tly us$ 9 family !rapy1 especially :5 family difficulties seem to be localiz$ ar\nd ! behavior ( rebelli\s or del9qu5t *ildr54 ,p>adoxical int5tion1 discuss$ 9 ,*apt] #aa1 c also be v helpful 9 m>riage & family !rapy4 ,in/ead ( try+ to re/ore a /ate ( balance betwe5 husb& & wife or among family memb]s--some?+ t usually /imulates ! c\ple or family to fight to hold on to its old habits--a !rapi/ #bjb enc\rages a /ate ( imbalance s t ! unbalanc$ sy/em falls ( its own weight4 ,! cure1 p>adoxically1 may lie 9 int5sify+ ! problem4 ,= example1 a wife has migra9es t prev5t h] f do+ h] family *ores4 ,a *ild ?r[s up :5 he is =c$ to g to s*ool4 ,bo? claim t !y j c't help x4 ,! !rapi/'s response might be1 ,i realize y c't help x4 ,:at ,i want y to d1 ,alice1 :5 y feel h\sehold *ores are j too mu*1 is to g to b$ & p]mit y\rself to h a migra9e4 ,don't fight x4 ,g ahead & h a bad heada*e4 ,x gives y "s relief1 s ,i want y to d ?is ?r\gh y\r own *oice4 ,& y1 ,johnny1 ,i want y to g into ! ba?room be=e y leave = s*ool & ?r[ up4 ,x is unpleasant1 b x hasn't hurt y4 ,if y ne$ to1 /ick y\r f+] d[n y\r ?roat4 ,i want y to take control & make y\rself ?r[ up ea* morn+ be=e go+ to s*ool4 ,& y1 ,alice1 y won't int]f]e or try to "m him2 let him alone4 ,b d rem9d him to g & ?r[ up4 ,9 a v %ort "t1 ! results ( ^! p>adoxical /rategies c be surpris+ly effective4 ,,applications ,,( ,,m>riage ,,& ,,family ,,!rapy ,z 9 all approa*es to !rapy1 ! effectiv5ess ( m>riage & family !rapy dep5ds on ! /r5g? ( ! cli5ts' desire to ov]come ! difficulties t h motivat$ !m to ask = help4 ,goodwill & commitm5t to *ange may or may n be !re4 ,sometimes a !rapi/ c help cli5ts become aw>e ( _! deep-seat$ b habitually ignor$ feel+s ( w>m? t[>d "o ano!r4 ,at o!r times1 m>riage !rapy may lead to sep>ation & divorce1 if a c\ple comes to realize t _! goals really are n compatible & :at ea* ne$s or wants f ! relation%ip ! o!r is n able or will+ to give4 ,m>riage !rapy & family !rapy are n magic w&s t c be wav$ ov] tr\ble to make ?+s bett]4 ,!rapi/s c make specific recomm5dations1 !y c help a c\ple or family become explicitly aw>e ( de/ructive patt]ns1 !y c po9t to & illu/rate con/ructive ways ( int]act+1 & !y c sometimes use !rapeutic /rategies to break old habits & make room = c>e & s5sitivity to ! ne$s ( wife1 husb&1 & *ildr54 ,^! int]v5tions f a !rapi/ c be v #bjc helpful1 p]haps ev5 crucial1 b !y are1 at mo/1 cataly/s = *ange3 real & la/+ *anges c only come f cli5ts !mselves4 ,m>riage or family !rapy is ideally an educational exp]i5ce4 ,:at wife1 husb&1 & *ildr5 d ) :at !y h le>n$ is1 9 ! end1 up to !m4 ,family !rapy has be5 especially effective 9 deal+ ) ^! problems3 99 problems due to conflicts among family memb]s 99 emotional di/urbances 9 *ildr5 99 "s cases ( s*izophr5ia :]e memb]s ( ! family are frequ5tly n well-individuat$--ea* p]son's id5tity is s b\nd up ) ! outlooks & behavior ( o!r family memb]s t no "o has a cle> s5se ( 8 or h] own p]sonal id5tity & sep>at5ess 99 problems t are int]lock+1 :]e ! difficulties ( "o memb] ( ! family _c be resolv$ )\t ! coop]ation ( ! o!rs 99 problems exp]i5c$ by a family :5 a *ild becomes old en\gh to leave home ,family !rapy has be5 mu* less effective 9 treat+ p>anoia 9 "o memb] ( ! family1 & behavioral problems /emm+ f sexual disord]s4 ,m>riage !rapy has be5 effective 9 help+ c\ples ) any ( ^! *>act]i/ics or problems3 99 ,!y communicate & int]act 9 ways t lead to conflict1 fru/ration1 ang]1 & unhapp9ess4 99 ,!y are insuffici5tly s5sitive to "o ano!r's ne$s4 99 ,!y h un/at$ & conflict+ expectations conc]n+ _! relation%ips4 99 ,!y w "w toge!r to help "o p>tn] ov]come individual difficulties4 #bjd #ae ,,*annel+ ,,aw>5ess3 ,ex]cise1 ,bi(e$back1 ,relaxation ,tra9+1 ,hypnosis1 & ,m$itation ,all ( ^! approa*es to !rapy s]ve to *annel aw>5ess 9 p>ticul> ways1 to provide a po9t ( focus = ! m9d4 ,!y are all processes t elim9ate di/ractions & enable y to direct y\r aw>5ess 9 ways t are basically diff]5t f normal1 ev]yday wak+ consci\sness4 ,special k9ds ( absorption or conc5tration *>act]ize ! !rapeutic uses ( ex]cise1 bi(e$back1 relaxation tra9+1 hypnosis1 & m$itation4 ,,! ,,psy*o!rapy ,,( ,,ex]cise ,= "s individuals :o already are or :o are will+ to become physically fit1 su/a9$ vigor\s ex]cise c significantly decrease symptoms ( t5sion1 anxiety1 & depression4 ,x is my cont5tion t1 j z pray]1 m$itation1 dream analysis & "s drug exp]i5ces op5 doors into ^! areas n usually accessible to u1 "u ! appropriate circum/ances sl[ long-di/ance runn+ op5s simil> doors4 ,! subjective exp]i5ce ( ! runn] appe>s ! same1 & he becomes revitaliz$ or re5]giz$ 9 a psy*ological #bje or spiritual or creative s5se4444 ,x is cle> to me t ?is is a di/9ct =m ( psy*o!rapy4 ,?addeus ,ko/rubala1 ,! ,joy ( ,runn+ ,_m /udies h be5 made & a small m\nta9 ( lit]ature has accumulat$ ab\t ! physical effects ( ex]cise4 ,h[ev]1 little att5tion has be5 paid to its psy*ological aspects1 p>ticul>ly 9 connection ) ! k9ds ( symptoms & problems t br+ p to psy*o!rapy4 ,psy*iatri/ ,?addeus ,ko/rubala 7#aicj- 7 has be5 "o ( ! pione]+ contributors to ! /udy ( ex]cise z a =m ( psy*o!rapy4 ,dr4 ,ko/rubala is a d$icat$ runn] :o has complet$ _m m>a?ons & :o uses runn+ z a !rapeutic approa* 9 8 practice4 ,mu* ( ! mode/ am\nt ( rese>* on ! psy*o!rapeutic value ( ex]cise has focus$ on runn+1 probably = ! foll[+ reasons3 ,fir/1 sl[ long-di/ance runn+ seems to be an anatomically natural activity = u1 ) our species' two relatively long legs4 ,second1 runn+ appe>s to be an especially effective way to d]ive specific !rapeutic b5efits f an a]obic activity4 ,&1 ( c\rse1 runn+ has rec5tly become v popul>4 ,mo/ ex]cise physiologi/s claim t ! physical1 & v likely also ! psy*ological1 effects ( o!r a]obic =ms ( ex]cise1 su* z bicycl+1 swimm+1 & cross-c\ntry ski+1 are ess5tially equival5t to runn+4 ,s1 until we "k o!rwise1 we w assume t :at is true ( runn+ is likely to be true ( o!r types ( ex]cise t make simil> dem&s on ! body1 & we w focus "h on runn+4 ,dr4 ,ko/rubala has attempt$ to describe a p>ticul> approa* to runn+ t seems to h def9ite psy*o!rapeutic value4 ,m is involv$ ?an donn+ a pair ( runn+ %oes & />t+ out1 z we w see4 ,dr4 ,ko/rubala has f\nd t runn+ is emotionally or m5tally !rapeutic "u c]ta9 conditions4 ,fir/1 y ne$ to make sure t y are 9 m$ically good condition to beg9 a !rapeutic runn+ program4 ,x w\ld be prud5t to h a ?or\gh physical &1 if y are ov] =ty1 also a /ress te/4 ,y ne$ to d w>m-up ex]cises1 :i* any good book on runn+ describes 9 detail1 & !n y ne$ to build up y\r endurance--gradually & pati5tly--until y c run a m9imum ( ?ree times a week = an h\r ea* "t1 )\t /opp+1 & #bjf ) a pulse rate ( at lea/ #ge p]c5t ( y\r maximum he>t rate4 7,y\r maximum he>t rate is #bbj beats p] m9ute m9us y\r age4 ,if y are #dj ye>s old1 y\r maximum he>t rate is #ahj4 ,sev5ty-five p]c5t ( #ahj yields a pulse rate ( #ace beats p] m9ute4 ,if y are #dj1 y w\ld want to run = an h\r s z to ma9ta9 a pulse rate ( #ace beats p] m9ute dur+ y\r run4 ,by way ( enc\ragem5t1 y may want to "k t #ge p]c5t ( a p]son's maximum he>t rate repres5ts1 = almo/ ev]yone1 a sl[1 easy jog47 ,second1 y mu/ h a noncompetitive attitude t[>d runn+4 ,:e!r y're comp>+ y\rself to o!rs or j try+ to beat y\r own runn+ record1 a competitive drive rivets y\r att5tion on a goal sep>ate f y\rself4 ,?is misplac$ emphasis w und]m9e ! !rapeutic value ( ! activity4 ,y also %\ld ei!r run alone or ) someone :o won't di/ract y by talk+4 ,direct y\r att5tion )9--to ! rhy?m ( y\r pace1 ! regul>ity ( y\r brea?+1 ma9ta9+ relaxation 9 y\r %\ld]s1 back1 & feet4 ,to prev5t di/raction x is also important to run 9 an area or ar\nd a track t is famili> to y4 ,= sl[ long-di/ance runn+ to h a !rapeutic effect1 y _c be a sightse]4 ,! novelty ( unfamili> surr\nd+s w di/ract y f be+ inn]-direct$1 :i* is !rapeutically important4 ,f9ally1 be aw>e ( ! physical risks4 ,if y beg9 to feel dizzy1 /op runn+4 ,9 hot wea!r1 dizz9ess is a fir/ w>n+ sign ( heat exhau/ion1 :i* c lead to heat/roke4 ,if y feel a snap 9 "o ( y\r runn+ muscles1 /op4 ,an int]nal snapp+ or popp+ noise c mean t a muscle or t5don has torn1 or a small bone has brok54 ,make sure y are all "r be=e resum+4 ,if y h a cramp-l pa9 9 y\r side1 :i* is v common1 try sl[+ d[n1 exhal+ =cefully1 giv+ a yell1 or s++4 ,y c (t5 keep go+1 & ! pa9 w subside4 ,if x does n1 or x gets worse1 y'll ne$ to /op to re/4 ,,:at ,,runn+ ,,z ,,!rapy ,,feels ,,l ,! psy*ological effects ( regul>1 sl[ long-di/ance runn+ c be impressive if y foll[ ! directions above4 ,dur+ ! fir/ tw5ty m9utes1 y may feel sl[ & /iff & n v inspir$ ab\t ! run4 ,y may f9d y\rself 9 a s\r mood4 7,!re is ev5 a t]m = ?is phase3 dysphoria47 #bjg ,p]suade y\rself t x is n important & keep go+4 ,betwe5 tw5ty & ?irty m9utes1 if y are dysphoric1 t feel+ may peak2 "s p ev5 beg9 to cry4 ,?is is n necess>ily depression2 x may actually feel good4 7,ano!r reason to run alone3 o!r p won't und]/& & may want to rescue y f y\r !rapeutic endeavor47 ,at "s po9t1 aft] ab\t ?irty m9utes ( runn+1 y w probably f9d t y\r m9d refuses to d any m problem solv+4 ,y /op worry+1 problems y may h be5 dwell+ on simply beg9 to feel di/a/eful1 & y\r m9d cle>s4 7,aft] a good run1 :5 y d return to ! problem1 y may well f9d t x is less difficult to ?9k ?r\gh47 ,betwe5 ?irty & =ty m9utes1 _m p beg9 to feel m op5--_! brea?+ beg9s to come m freely1 & _! :ole sy/em seems to "w m smoo?ly & ) less ef=t4 ,?is c be a wond]ful feel+4 ,aft] y h be5 runn+ = =ty m9utes1 ! fir/ alt]ations 9 y\r consci\sness may beg94 ,y\r s5ses beg9 to feel m al]t1 m alive4 ,?+s seem m vivid--! colors ( leaves1 ! song ( a bird1 ! fre%ness ( ! air4 ,runn]s :o h exp]i5c$ ?is say t ?is natural1 vivid1 fre% s5se ( p]ception is unique2 to "s ext5t x may resemble ! exp]i5ce t comes f m$itation1 bi(e$back1 or drugs4 ,?is exp]i5ce seems n to occur be=e =ty m9utes ( runn+4 ,x may be an exp]i5ce ( mild euphoria1 or y may feel x z a m>k$ increase 9 ae/hetic s5sitivity or z a s5se ( gr[+ inn] s]5ity4 ,,applications ,,( ,,ex]cise ,,z ,,psy*o!rapy ,i'm sure t ^! exp]i5ces are closely relat$ to m$itation4 ,! cle>+ ( consci\sness1 ! ability to f9d a c5tral focus )91 ! delight ( a cle> m9d1 ! s5se ( refre%m5t ( ! s\l are report$ bo? by ^? :o practice m$itation & by long-di/ance runn]s4 ,! diff]5ce betwe5 ! two te*niques is 9 ! physical effects ( ! runn+4 ,x is z if ^? :o m$itate h f\nd "o half ( ! picture4 ,! runn]s :o j compete & d n rea* = ! psy*ological aspects h f\nd ! o!r half4 ,! runn]s :o are able to sl[ d[n & se>* = ! psy*ic aspects w h bo?--! s\l & ! body4 ,?addeus ,ko/rubala1 ,! ,joy ( ,runn+ #bjh ,ev5 ?\gh a]obic ex]cise su* z sl[ long-di/ance runn+ c produce a feel+ ( mod]ate depression dur+ ! fir/ ?irty m9utes1 p :o h mod]ate1 l+]+ depressions 9 daily life (t5 f9d t1 z describ$ above1 depression disappe>s aft] ab\t =ty m9utes4 ,ang] & ho/ility also seem to be mu* r$uc$ aft] ab\t ?irty m9utes ( runn+4 ,! repetitive rhy?m & su/a9$ ex]tion ( sl[ long-di/ance runn+ appe> to tire ! consci\s m9d4 ,_m anxieties1 t5sions1 worries1 feel+s ( guilt1 ang]1 & depression lift4 ,! easily di/ract$1 con/antly n]v\s & %ift+ focus ( ev]yday consci\sness gives way to a s5se ( integration1 ( be+ "o ) y\rself & ! activity ( runn+4 ,o *e/nut tree1 great root$ blossom]1 ,are y ! leaf1 ! blossom or ! bole8 ,o body sway$ to music1 ,o bright5+ glance1 ,h[ c we "k ! danc] f ! dance8 ,w4 ,b4 ,yeats1 ,among ,s*ool ,*ildr5 ,! !rapeutic use ( runn+ appe>s to (f] ! foll[+ b5efits3 99 increases m5tal en]gy1 acuity1 & conc5tration 99 /r5g!ns self-confid5ce & a s5se ( p]sonal wor? 99 increases a capacity = "w s t y feel less tir$ at ! end ( ! day 99 dim9i%es smok+1 dr9k+1 & o!r unheal?y habits 99 helps ^? ) eat+ disord]s--:o ei!r are ov]weight or dang]\sly und]weight--*ange _! eat+ habits 99 less5s or lifts depression 99 improves relation%ips t 7 de/ructive or motivates p to sep>ate 99 r$uces or elim9ates confus$ & irrational ?\ght processes 9 "s s*izophr5ic pati5ts ,treat+ ,depression ,9 p>ticul>1 runn+ z describ$ "h appe>s to be especially effective 9 treat+ depression3 444 x's h>d to run & #bji feel sorry = y\rself at ! same "t4#a ,runn+ t5ds to increase y\r s5se ( indep5d5ce & self-confid5ce1 :i* h be5 weak5$ if y h be5 depress$4 ,psy*o!rapy & drug !rapy1 9 contra/1 may enc\rage dep5d5cy on ! !rapi/ or psy*iatri/4 #a ,james ,fixx1 ,! ,complete ,book ( ,runn+ 7,new ,york3 ,r&om ,h\se1 #aigg71 p4 #af4 ,dr4 ,ko/rubala has notic$ t long-di/ance runn+ (t5 greatly r$uces or ev5 elim9ates ! typical e>ly morn+ awak5+ & insomnia ( ! *ronically depress$ p]son4 ,?is p>ticul>ly pa9ful symptom involves j>r+ awake to a new day to be fac$--a day ( anxiety1 fe>s1 & hopelessness to be combat$4 ,if y h exp]i5c$ ?is1 y are probably famili> ) wak+ up too e>ly1 at :at ! ,sw$es call ! h\r ( ! wolf1 ly+ 9 b$1 exhau/+ y\rself ) cru%+ worries1 despair1 & te>s1 & beg9n+ ! day 9 a /ate ( emotional exhau/ion4 ,ko/rubala has f\nd t z depress$ p cultivate ! habit ( long-di/ance runn+1 ^! e>ly morn+ ordeals (t5 gradually subside & disappe>4 ,a ,briti% m$ical gr\p l$ by ,dr4 ,malcolm ,c>ru!rs discov]$ t individuals :o ex]cise vigor\sly produce increas$ levels ( ! hormone ep9ephr9e1 :i* c\nt]acts depression4 ,app>5tly1 /rong ex]cise = ev5 t5 m9utes d\bles ! normal level ( ep9ephr9e2 ! effects ( ! height5$ level ( ! hormone c be fairly long-la/+4 ,ano!r /udy1 by psy*iatri/ ,john ,grei/ at ! ,univ]sity ( ,wiscons91 reveal$ t "o gr\p ( s]i\sly depress$ pati5ts b5efit$ m f a t5-week session ( !rapeutic runn+ ?an ano!r gr\p b5efit$ f traditional !rapy4 ,to summ>ize rese>* f9d+s on ex]cise z a treatm5t = depression3 99 ,to be effective1 vigor\s ex]cise mu/ be done regul>ly no less ?an ?ree times a week1 & pref]ably at lea/ five times a week1 = p]iods la/+ betwe5 ?irty m9utes & an h\r4 7,dr4 ,ko/rubala uses an h\r z a goal47 99 ,al?\gh runn+ & runn+ comb9$ ) walk+ are ! mo/ commonly us$ !rapeutic =ms ( ex]cise1 any regul> a]obic ex]cise is likely to produce ! same #baj antidepressant effects :5 done = proportional p]iods ( ex]tion4 99 ,/udies ov] ! pa/ t5 ye>s %[ t less5+ depression by means ( ex]cise is mo/ successful = p]sons ) mild to mod]ate depression1 b vigor\s ex]cise t5ds n to b5efit pati5ts ) sev]e depression4#b #b ,john ,h4 ,grie/ & ,james ,w4 ,jeff]son1 ,depression & ,its ,treatm5t 7,wa%+ton1 ,,dc3 ,am]ican ,psy*iatric ,press1 #aihd71 p4 #fc4 ,less5+ ,anxiety ,!rapeutic runn+ also t5ds appreciably to less5 anxiety4 ,a rese>* /udy conduct$ by ,dr4 ,h]b]t ,a4 de,vries ( ! ,univ]sity ( ,s\!rn ,cali=nia ,s*ool ( ,m$ic9e & ,g5e ,m4 ,adams ( ,,usc's ,g]ontology ,c5t] f\nd t fifte5 m9utes ( mod]ate ex]cise dim9i%$ anxiety m 9 p ag$ fifty-two to sev5ty ?an did #djj-milligram doses ( meprobamate1 a widely prescrib$ tranquiliz]4 ,= ,s*izophr5ics ,!rapeutic runn+ also seems to b5efit s*izophr5ic pati5ts4 ,s*izophr5ia is a complex1 difficult-to-treat illness t affects approximately #a p]c5t ( ! _w's population4 ,x is no respect] ( p>ticul> cultures4 ,!re are _m =ms ( ! illness1 b all are *>act]iz$ by disabl+ blockages to normal human int]relation1 /range behavior1 loss ( contact ) reality1 & )drawal1 p>anoia1 or halluc9ations4 ,aga91 ,dr4 ,ko/rubala has attempt$ to help pati5ts ) ?is condition ?r\gh a comb9$ program ( m$ication1 psy*o!rapy1 & !rapeutic runn+4 ,al?\gh he is c>eful to emphasize t controll$ /udies h yet to be made1 8 judgm5t ab\t ! pati5ts he has treat$ is t 444 us+ ?is =m ( runn+ !rapy 444 ,i h se5 !m *ange dramatically4 ,!y beg9 to lose _! symptoms2 m$ication c be r$uc$ & (t5 discont9u$2 & !y h pick$ up ! c\rse ( _! lives until sev]al are no long] recognizable z s*izophr5ics at all--ev5 by pr(essional obs]v]s4#c #c ,?addeus ,ko/rubala1 ,! ,joy ( ,runn+ 7,philadelphia3 ,j4 ,b4 ,lipp9cott1 #aigf71 p4 #abi4 #baa 444 ,i h come to ! conclusion t runn+1 done 9 a p>ticul> way1 is a natural =m ( psy*o!rapy4#d #d ,ko/rubala1 ,! ,joy ( ,runn+1 p4 #aai ,! ,risks ,s9ce !rapeutic runn+ appe>s to be ( psy*iatric value1 x is n surpris+ t x1 l any attempt to heal1 may h pot5tial risks4 ,aside f ! obvi\s pot5tial = sports-relat$ injuries1 !re is a specific risk3 physical addiction4 ,dr4 ,william ,glass]1 ^: approa* to psy*o!rapy we discuss$ 9 ! section deal+ ) reality !rapy 7,*apt] #aa71 agrees ) ,ko/rubala t !rapeutic runn+ is addictive4 ,glass] calls x a positive addiction1 s9ce--unlike ! use ( alcohol1 b>biturates1 & opiates--runn+ is con/ructive & !rapeutic4#e ,h[ev]1 l alcoholism & drug addiction1 !rapeutic runn+ does produce v real )drawal symptoms if a d$icat$ runn] _c cont9ue to run1 :e!r tempor>ily because ( an injury or illness1 or p]man5tly4 ,)drawal symptoms c be surpris+ly sev]e3 prim>ily1 /rong anxiety & insomnia1 b sometimes also re/lessness1 sweat+1 weight ga9 or loss1 &_/or depression4 #e ,william ,glass]1 ,positive ,addiction 7,new ,york3 ,h>p] & ,r[1 #aigf71 ,*apt] #e4 7,*apt] #f ( 8 book is devot$ to ano!r positive addiction1 m$itation47 ,,bi(e$back ,9 psy*o!rapy1 especially useful = cli5ts ) problems involv+ anxiety1 depression1 phobias1 & insomnia1 :o w b5efit f le>n+ h[ to less5 _! own t5sion4 ,mo/ ( u c draw a relatively cle> l9e betwe5 ! physiological processes we c control & ^? we _c4 ,unless an illness or accid5t or h&icap int]f]es1 we h volunt>y control ov] _m muscles1 b !re are _m t1 =tunately1 "w )\t our consci\s int]cession3 ! he>t beats day & night1 our lungs fill & empty1 our dige/ive processes are automatic4 ,except = p :o h volunt>y control ov] ! muscles t move _! e>s1 we are all m or #bab less equally end[$1 & equally limit$1 9 :at physical processes we are able to influ5ce4 ,until ! developm5t ( bi(e$back1 !re 0 only "o way to ext5d self-control beyond ! normal range3 ?r\gh a discipl9$ & "t-consum+ practice su* z yoga4 ,exp]i5c$ practition]s ( yoga claim t /udy+ yoga ov] a p]iod ( ye>s has giv5 !m a s5se ( p]sonal integration & m5tal c5t]+ simil> to :at we w see 9 connection ) ! practice ( m$itation4 ,physical & emotional flexibility also seem to result f long-t]m yoga practice4 ,"s yogis h ext5d$ _! range ( control ov] inn]1 normally involunt>y processes 9 dramatic ways4 ,"s c cause _! he>t rate to increase to five times its re/+ rate4 ,"s are able to cause a t5-degree temp]ature diff]5ce betwe5 ! ?umb & little f+] ( ! same h&3 "o side is flu%$ & hot1 ! o!r side cool & pale4 ,_m o!r =ms ( self-control h be5 docum5t$1#f b acquir+ ^! special skills ?r\gh ! practice ( yoga takes ye>s ( discipl9e1 conc5tration1 & t5acity4 ,b ! ye>s ( d$ication seem also to be indisp5sable if "o is to develop ! qualities ( inn] tranquility & /r5g? s\ght by yogis4 #f ,see1 e4g41 ,mircea ,eliade1 ,yoga3 ,immortality & ,fre$om 7,pr9ceton1 ,,nj3 ,pr9ceton ,univ]sity ,press1 #aieh74 ,bi(e$back has greatly %ort5$ ! yogis' road to consci\s control ( "s physical processes1 &1 9 turn1 x has become ! ma9 contribution te*nology has made s f> to psy*o!rapy4 ,_m ( ! physical processes t bi(e$back tra9+ c help y le>n r quickly to control influ5ce y\r emotional well-be+4 ,bi(e$back equipm5t c enable y to le>n1 = example1 h[ to w a /ate ( muscul> relaxation1 h[ to ga9 a measure ( control ov] y\r physical response to /ress or pa91 ev5 h[ to raise or l[] y\r blood pressure or he>t or respiration rate4 ,to use bi(e$back equipm5t1 electrodes are tap$ to ! areas ( y\r body t are to be monitor$4 ,!y may measure su* ?+s z sk9 temp]ature1 sk9 moi/ure1 muscle t5sion1 pulse & brea?+ rates1 or bra9 wave patt]ns4 ,! fe$back f :i* y le>n to control normally involunt>y processes occurs :5 ! measurem5ts made by ! in/rum5ts are ext]naliz$ = y3 y are able to see a patt]n on a comput] #bac monitor or oscilloscope or he> a *ang+ tone t gives y imm$iate in=mation ab\t y\r physical responses4 ,9 o!r words1 bi(e$back is an electronic way ( repres5t+ inn] processes ext]nally t are usually automatic1 involunt>y1 & unconsci\s4 ,,physical ,,applications ,frequ5tly1 & relatively quickly1 _m p are able to le>n h[ to control _m ( _! int]nal responses v well4 ,bi(e$back c sometimes be an alt]native to us+ m$ication to r$uce t5sion or pa94 ,its range ( applications has gr[n trem5d\sly4 ,"h are "s examples ( its uses3 ,a woman 0 badly injur$ 9 an automobile accid5t4 ,on "o side ( h] face h] facial n]ve 0 sev]$1 leav+ h] unable to move any "p ( ! left side ( h] face & unable to close or bl9k h] left eye4 ,surgeons decid$ to splice ! sev]$ facial n]ve to a n]ve 9 h] neck-%\ld] muscle4 ,once ?is 0 done1 ! woman c\ld %rug or twit* h] %\ld]1 & 9 ?is way cause ! p>alyz$ side ( h] face to move1 & bl9k h] left eye4 ,h[ev]1 ! movem5ts ( ! left side ( h] face 7 uncoord9at$1 spa/ic1 & n syn*ron\s ) ! movem5ts ( ! un9jur$ "r side ( h] face4 ,bi(e$back tra9+ seem$ to (f] a possible solution4 ,electrodes 7 tap$ to ! injur$ side ( h] face4 ,! electrical activity ( muscles 9 ! damag$ area 0 display$ on a scre51 along ) ! patt]n t w\ld be produc$ by undamag$ facial n]ves & muscles4 ,! woman's task 0 to wat* ! two patt]ns & someh[ le>n by inn] exp]im5t h[ to control ! left side ( h] face s its movem5ts w\ld mat* ! normal patt]n & w\ld !n coord9ate ) movem5ts ( ! o!r side4 ,h] tra9+ la/$ = sev]al mon?s4 ,because ( h] p]si/5ce & h>d "w1 %e 0 successful 9 le>n+ to mat* ! normal patt]n2 %e 0 n[ able to move ! two sides ( h] face 9 symmetrical h>mony4 ,o!r successful physical applications ( bi(e$back !rapy include ^!3 99 controll+ high blood pressure 99 le>n+ to raise blood pressure 9 cases ( sp9al injuries #bad t block ! automatic rais+ ( blood pressure :5 a p]son /&s up 7excessively l[ pressure causes !m to fa9t7 99 cop+ m effectively ) a/hma attacks 99 elim9at+ migra9e heada*es 99 help+ *ildr5 ) c]ebral palsy control muscle spasms 99 help+ /roke victims ) proprioception problems 79 :i* !y lose ! s5se ( :]e _! arms & legs are 9 space7 99 tea*+ pati5ts ) circulation problems 7e4g41 blood clots 9 ! legs7 to dilate _! blood vessels1 rega9+ movem5t & r$uc+ pa9 99 assi/+ /utt]]s by help+ !m become aw>e ( unnecess>y & int]f]+ muscle contractions !y h come to make habitually :5 !y speak & tea*+ !m h[ to relax ^! muscles 99 r$uc+ t5sion & pa9 9 ar?ritis pati5ts ,to date1 ( all ! areas to :i* x has be5 appli$1 bi(e$back has be5 mo/ successful = pati5ts :o are physically p>alyz$ or h movem5t disord]s4 ,,psy*o!rapeutic ,,applications ,bi(e$back has be5 us$ successfully 9 psy*o!rapy 9 ^! ways3 99 tea*+ g5]al relaxation me?ods1 :i* c be useful to _m p :o h problems t involve anxiety1 depression1 or phobias 99 assi/+ p ) insomnia1 also ?r\gh relaxation te*niques 99 tea*+ p h[ to recognize effective m$itation by mak+ !m aw>e ( p]iods dur+ sessions ( m$itation :5 _! bra9wave patt]ns sl[ 7see ! la/ section 9 ?is *apt]1 on m$itation7 ,increas+ly1 bi(e$back is be+ us$ to treat emotional disord]s 9 conjunction ) bo? psy*o!rapy & m$ication4 ,x is "o ( ! ways available to u to enl>ge ! range ( our consci\s control ov] ourselves & our lives4 #bae ,,relaxation ,,tra9+ ,prim>ily a cop+ /rategy to help p cont9ue to function 9 an environm5t ( /ress4 ,! p]vasive ph5om5on ( /ress is ! hidd5 epidemic ( ! ,unit$ ,/ates & o!r highly indu/rializ$ c\ntries4 ,x is associat$ ) high blood pressure1 h>d5+ ( ! art]ies1 /rokes1 ulc]s1 colitis1 & a ho/ ( o!r physical conditions4 ,& sev]e /ress endur$ too long leads to emotional breakd[n4 ,all physical mat]ials c be load$ or /ress$ to a c]ta9 po9t beyond :i* !y di/ort1 snap1 fracture1 or break4 ,/ress loads human be+s physically z well z emotionally4 ,any *ange--:e!r = good or = ill--is a /ressor4 ,z human be+s1 we are n simple eng9e]+ mat]ials t =m simple cracks or breaks1 & :5 /ressful ev5ts are /rong en\gh1 we beg9 to crack or break 9 ways t are consid]ably m complex4 ,physical disease1 emotional disord]s1 & m5tal illnesses are ! cracks or breaks t occur 9 human mat]ial4 ,/ati/ics %[ t common =ms ( sev]e /ress d cause u to break4 ,= example1 comp>$ ) o!rs ! same age1 t5 times m p die dur+ ! ye> foll[+ ! dea? ( _! husb&s or wives4 ,9 ! ye> aft] a divorce1 ex-sp\ses h an illness rate twelve times high] ?an m>ri$ p ! same ages4 ,9 addition1 *ronic ang]1 anxiety1 & depression appe> to weak5 ! body's immune sy/em1 increas+ ! likelihood ( s]i\s disease4 ,individuals d1 ( c\rse1 h diff]5t emotional break+ po9ts1 b we "k t prolong$ high levels ( anxiety erode a p]son's psy*ological integration4 ,:at results is n]v\s breakd[n--a t]m t is vague & means little m ?an a bl[n fuse due to emotional ov]load4 ,! aft]ma? ( su* an ov]load may leave a p]son ) depression1 anxiety1 & ! inability to function z usual = a consid]able p]iod ( "t4 ,relaxation tra9+1 along ) ! o!r !rapies discuss$ 9 ?is *apt]1 is an antidote or prev5tion = human breakage br\ght ab\t by excessive /ress4 ,! c5tral belief on :i* relaxation tra9+ is bas$ is t y _c be t5se & anxi\s if y are physically v relax$4 #baf ,!re are two ma9 approa*es to relaxation tra9+4 7,we h already briefly discuss$ !m 9 ,*apt] #ab 9 connection ) des5sitization47 ,9 bo? approa*es y beg9 by recl9+ or ly+ d[n 9 a quiet room4 ,relaxation c !n be a*iev$ ?r\gh t5sion & release or ?r\gh sugge/ion4 ,9 ! =m]1 y t5se a giv5 muscle gr\p1 hold+ ! t5sion = five to t5 seconds1 !n release ! t5sion & exp]i5ce ! relief f t5sion1 or relaxation4 ,9 ! latt]1 y consci\sly sugge/ to y\rself t a gr\p ( muscles feels w>m1 heavy1 v heavy1 & relax$1 s9k+ into ! recl9] or b$ or floor4 ,bo? approa*es aim to a*ieve two ?+s3 to br+ ab\t deep1 progressive muscul> relaxation & to increase y\r s5sitivity to ! pres5ce ( t5sion 9 y\r body :5 x exi/s4 ,relaxation tra9+ is a le>n$ skill4 ,if y practice x regul>ly--t is1 daily1 = at lea/ sev]al weeks--y c ga9 increas$ control ov] y\r major muscle gr\ps--^? ( ! arms1 legs1 %\ld]s1 back1 abdom51 neck1 & face4 ,y gradually le>n to recognize ev5 l[ levels ( t5sion 9 ^! muscles s t ! t5sion c be elim9at$ consci\sly4 ,ev5tually1 z y le>n h[ to control physical relaxation1 y are able to a*ieve deep relaxation 9 increas+ly %ort] p]iods ( "t4 ,aft] regul> practice ov] a p]iod ( mon?s1 _m p1 :5 !y face a sudd5ly upsett+ situation1 c quickly (fset _! emotional & physical reactions to /ress by induc+ a calm & relax$ /ate 9 !mselves4 ,!y are able to neutralize ! /ressor's pot5tial = do+ damage4 ,if y c le>n to d ?is1 y h le>n$ a skill 9 controll+ y\r own life t is ( great value4 ,x is a survival skill t c help y protect y\rself aga9/ be+ worn d[n by /ressful ev5ts t o!rwise ev5tually lead to le>n$ habits ( anxiety & t5sion4 ,once =m$1 ^! habits c be v difficult to get rid (4 ,= emotionally di/urb$ p]sons1 relaxation tra9+ te*niques are useful prim>ily z an adjunct to psy*o!rapy or drug !rapy & c be helpful 9 r$uc+ t5sion & anxiety4 ,!y are ways ( treat+ symptoms2 !y c help y cont9ue to cope ) /ressful situations4 ,x is ano!r "q :e!r x is 9 y\r be/ int]e/ to cont9ue 9 a situation t causes y en\gh /ress t relaxation tra9+ becomes a ne$$ crut*4 ,sometimes x is wis] to *ange an unsatisfactory situation or to attempt to *ange y\r attitudes1 values1 or behavior #bag ?an x is to le>n skills s t y c keep do+ ! same /ressful & p]haps unsatisfy+ ?+ day aft] day4 ,relaxation tra9+ is a cop+ /rategy4 ,by itself1 x _c resolve ! fundam5tal "q3 :e!r x is bett] to le>n h[ to numb y\rself to an unhappy situation1 to leave x1 or to face ! possibility t y\r /ress is caus$ by inn] conflicts & unreali/ic attitudes r ?an ext]nal factors4 ,if y _c or d n want to leave a /ressful environm5t1 te*niques ( relaxation tra9+ may b5efit y4 ,if y feel ! ma9 problems are )9 y1 !n psy*o!rapy may be ! be/ alt]native4 ,& sometimes1 ?r[+ 9 ! t[el1 decid+ 9 favor ( a *ange ( c>e]1 m>riage1 place to live1 or way ( life may be mo/ !rapeutic & p]sonally fulfill+4 ,x c (t5 be h>d to "k :i* alt]native is be/4 ,c\nsel+ may help4 ,talk+ ) good fri5ds may help4 ,lett+ "t pass may help4 ,usually1 ignor+ discom=t w n help2 /ress has a way ( comp\nd+ & we>+ y d[n4 ,wait+ too long1 usually out ( fe> ( fac+ a ne$ = "s =m ( *ange1 is itself a s\rce ( int]nal /ress--( worry & anxiety t w n g away until y d some?+ to put a /op to do+ no?+4 ,,hypnosis ,an approa* to !rapy t c h f>-rea*+ b5eficial effects = p ) _m diff]5t k9ds ( problems1 especially useful = p]sons :o are /rongly motivat$ to *ange & c feel a deep s5se ( confid5ce 9 ! humanity & compet5ce ( _! !rapi/4 ,hypnosis is v old4 ,anci5t ,egyptian records indicate t prie/s ma9ta9$ temples ( sleep devot$ to heal+ ! ill & tr\bl$4 ,! prie/s are ?\ght to h us$ hypnotic induction ( sleep & to h (f]$ assurance t pati5ts w\ld get well4 ,_m c5turies lat]1 ,franz ,anton ,mesm] 7#agcd-ahae7 develop$ a me?od = induc+ a hypnotic trance /ate 7he associat$ x ) sleepwalk+7 & claim$ t !rapy (t5 #bah 0 m effective :5 pati5ts 7 9 a trance4 ,hypnosis 0 lat] us$ by ,jean-,m>t9 ,*>cot 7#ahbe-ahic7 at ! ,p>is ,hospital ( ,salptrire2 ,*>cot 0 "o ( ,freud's tea*]s4 ,dur+ ,_w ,w> ,,ii1 hypnosis 0 us$ to treat soldi]s ) amnesia1 p>alysis1 & pa94 ,s9ce !n1 x has be5 us$ frequ5tly by cl9ical psy*ologi/s & psy*o!rapi/s4 ,mu* is /ill n und]/ood ab\t ! m5tal & physiological me*anisms involv$ 9 hypnosis4 ,!y are difficult to def9e because !y seem to assume _m diff]5t =ms 9 diff]5t p1 dep5d+ on _! p]sonalities & _! moods at ! "t4 ,hypnosis probably occurs 9 daydream+ to "s ext5t2 x probably is also involv$ :5 a "m lulls h] *ild to sleep or :5 a cu/om] succumbs to sugge/ions f a salesp]son4 ,we all seem to be--vaguely & to "s degree--famili> ) ! ph5om5on1 yet we rema91 p>adoxically1 ignorant ( its exi/5ce4 ,,:at ,,hypnosis ,,is ,,l ,= mo/ p1 ! exp]i5ce ( hypnosis is some?+ ( a letd[n4 ,!y anticipate t !y w h an extraord9>y exp]i5ce 9 a trance /ate1 & yet :at actually happ5s is v simil> to _! probably famili> exp]i5ce ( drift+ into a /ate ( relax$ di/raction f "t to "t :5 daydream+4 ,(t5 :at happ5s :5 we daydream is t our att5tion is focus$ on an object1 & we gradually relax & beg9 to drift into a /ate ( p>tial aw>5ess4 ,! phone may !n r+1 b = a mom5t x c be uncle> :e!r we are j imag9+ ?is4 ,! hypnotic /ate induc$ by a tra9$ hypno!rapi/ is v simil>4 ,:5 9 a hypnotic trance1 y nev] become unconsci\s2 y\r m9d cont9ues to be active4 ,z y g gradually into a deep] trance1 y\r brea?+ & he>t rates t5d to sl[1 & y feel increas+ly m deeply relax$4 ,usually1 ! exp]i5ce is "o ( be+ lull$ into a /ate ( calm repose4 ,sometimes--= example1 9 =m] surg]y pati5ts :o h _h unpleasant exp]i5ces ) ane/hesia--hypnosis may cause p to become anxi\s or fright5$ & to refuse to cont9ue4 ,y relax physically :ile 9 a hypnotic trance4 ,y w slump 9 y\r *air2 y\r brea?+ becomes sl[ & deep2 y move v little4 ,9 o!r cultures1 h[ev]1 trance /ates take v #bai diff]5t =ms4 ,behavior may become ec/atic1 ev5 viol5t2 individuals may beg9 to dance fr5etically & to sp9 ab\t1 z 9 ! case ( ,alg]ian d]vi%es4 ,b 9 ,we/]n society1 hypnotic trance usually takes ! =m ( deep1 passive relaxation4 ,aft] _! fir/ exp]i5ce ) hypnosis1 mo/ p t5d to disbelieve t !y h really be5 9 a trance /ate4 ,!y realize !y h be5 pleasantly relax$1 b !y feel t hypnosis has n occurr$4 ,cli5ts :o are suspici\s1 ho/ile1 or feel ?reat5$ by ! exp]i5ce1 or :o d n tru/ ! !rapi/1 t5d to resi/ hypnosis4 ,frequ5tly1 on ! o!r h&1 cli5ts :o are extremely anxi\s & feel greatly 9 ne$ ( help turn out to be especially good c&idates = hypnosis4 ,if _! fir/ exp]i5ce ) hypnosis is com=table1 safe1 & pleasant1 cli5ts w usually all[ !mselves to drift into a deep] trance /ate 9 subsequ5t sessions4 ,_m te*niques exi/ to induce hypnosis4 ,commonly1 !y make use ( ! well-kn[n me?od 9 :i* y are ask$ to fix y\r att5tion on an object--a co91 a /one1 a p5dant--:ile ! hypno!rapi/ speaks s(tly 9 a monotone1 sugge/+ t y are relax+ ev] m deeply1 t y\r eyes are gett+ heavy1 & s on4 ,milton ,h4 ,erickson 7#aija-aihj7 has be5 "o ( ! lead+ ,am]ican contributors to rec5t developm5ts 9 cl9ical hypnosis4 ,8 ideas h be5 among ! mo/ creative1 imag9ative1 & subtle 9 ! field4 ,he is well kn[n = 8 indirect induction te*niques1 :i*1 because ( ! complex & unusual p]spective !y reflect1 we _c deal ) at any l5g? "h4 ,!y are te*niques t frequ5tly induce a trance /ate )\t ! cli5t's be+ 9 ! slighte/ way aw>e t ?is is happ5+4 ,dr4 ,erickson is (t5 able to induce hypnosis only by means ( a h&%ake4 ,an example may give "s g5]al idea ( 8 approa*4 ,dr4 ,erickson describes ?is te*nique3 ,:5 ,i beg9 %ak+ h&s1 ,i d s normally4 ,! hypnotic t\* !n beg9s :5 ,i let loose4 ,! lett+ loose becomes trans=m$ f a firm grip into a g5tle t\* by ! ?umb1 a l+]+ draw+ away ( ! little f+]1 ! fa9t bru%+ ( ! subject's h& ) ! middle f+]--j en\gh vague s5sation to attract ! att5tion4 ,z ! subject gives att5tion to ! t\* ) y\r ?umb1 y %ift to a t\* ) y\r little f+]4 ,z y\r subject's att5tion foll[s t1 y %ift to a t\* ) y\r middle f+] & !n aga9 to ! ?umb4444 #bbj ,! subject's )drawal f ! h&%ake is arre/$ by 8 att5tion ar\sal1 :i* e/abli%es 444 an expectancy4 ,!n almo/1 b n q simultane\sly 7to ensure sep>ate neural recognition71 y t\* ! und]surface ( ! h& 7wri/7 s g5tly t x b>ely sugge/s an upw>d pu%4 ,?is is foll[$ by a simil> utt]ly slight d[nw>d t\*1 & !n ,i sev] contact s g5tly t ! subject does n "k exactly :5--& ! subject's h& is left go+ nei!r up nor d[n1 b cataleptic4 ,sometimes ,i give a lat]al & m$ial t\* s t ! h& is ev5 m rigidly cataleptic4444 ,!re are sev]al colleagues :o won't %ake h&s ) me1 unless ,i assure !m fir/1 because !y develop$ a pr(\nd glove anae/hesia :5 ,i us$ ?is proc$ure on !m4 ,i %ook h&s ) !m1 look$ !m 9 ! eyes1 444 rapidly immobiliz$ my facial expression1 & !n focus$ my eyes on a spot f> beh9d !m4 ,i !n sl[ly & imp]ceptibly remov$ my h& f !irs & sl[ly mov$ to "o side out ( _! direct l9e ( vision4#g ,"h is a *>act]i/ic reaction ( "o ( ,erickson's colleagues to 8 proc$ure3 ,i _h he>d ab\t y & ,i want$ to meet y & y look$ s int]e/$ & y %ook h&s s w>mly4 ,all ( a sudd5 my arm 0 gone & y\r face *ang$ & got s f> away4 ,!n ! left side ( y\r head began to disappe>1 & ,i c\ld see only ! "r side ( y\r face until t sl[ly vani%$ also4444 ,y\r face sl[ly came back1 & y came close & smil$4444 ,!n ,i notic$ my h& & ask$ y ab\t x because ,i c\ldn't feel my :ole arm4 ,y said to keep x t way j a little :ile = ! exp]i5ce4#g #g ,milton ,h4 ,erickson1 ,erne/ ,l4 ,rossi1 & ,%eila ,i4 ,rossi1 ,hypnotic ,realities3 ,! ,induction ( ,cl9ical ,hypnosis & ,=ms ( ,indirect ,sugge/ion 7,new ,york3 ,irv+ton ,publi%]s1 #aigf71 pp4 #ajh-aji4 ,,applications ,,( ,,hypnosis ,x is mu* easi] to br+ ab\t a hypnotic trance ?an to "k h[ to make effective !rapeutic use ( ! trance /ate once x is produc$4 ,dep5d+ on ! dep? ( trance t y w accept1 ^! are ! k9ds ( goals t c be a*iev$3 ,9 a light trance1 y\r eyes are clos$1 y are physically #bba relax$1 & x is possible to convey to y1 = example1 t y are unable to move an arm4 ,at ?is /age1 ! !rapi/ c (t5 be effective 9 (f]+ y support & enc\rag+ y to beg9 to make *anges 9 y\r behavior4 ,9 a m$ium trance1 relaxation is /ill deep]4 ,a p>tial ane/hesia ( a h& or arm c be a*iev$1 & y w comply 9 a sl[1 semiautomatic way ) in/ructions f ! !rapi/4 ,9 ?is /ate1 _m cli5ts c le>n r quickly h[ to br+ ab\t self-hypnosis1 :i* !y c !n practice on _! own4 ,at ?is /age1 x is sometimes possible to sugge/ gradual p]sonality *anges4 ,9 a deep trance1 m ext5sive ane/hesias are possible4 ,a !rapi/ c enc\rage y to exp]i5ce emotional *anges1 to halluc9ate1 & to regress to a y\ng] age--i4e41 to re-exp]i5ce memories ( pa/ ev5ts & to feel & behave z y did at t "t4 ,9 a deep trance /ate1 x is possible to use hypnotic des5sitization te*niques to help y ov]come anxieties & fe>s4 ,hypno!rapy l5ds itself well to use on y\r own4 ,once y h le>n$ h[ to induce light trance /ates on y\r own1 y c beg9 to sugge/ c]ta9 attitudes1 feel+s1 or behavioral *anges y w\ld l to br+ ab\t 9 y\rself4 ,be+ successful at ?is--z ) any skill--requires regul> practice & regul> & gradual /r5g!n+ ( ! habits t are be+ =m$4 ,"s psy*o!rapi/s w make a audio record+ = ! individual cli5t to use at home on a daily basis4 ,hypnosis has be5 us$ to treat _m problems1 includ+ ^!3 ulc]s frigidity impot5ce heada*es & migra9es insomnia ar?ritic pa9 colitis ta*yc>dia obesity depression phobias antisocial behavior #bbb di/urb$ *ildr5 amnesia /utt]+ n]v\s tics sexual inhibitions d5tal anxiety & pa9 he>t palpitations abdom9al cramps t5sion & anxiety ov]eat+ r$uction or elim9ation ( smok+ ,bo? m5 & wom5 are equally hypnotizable4 ,*ildr5 are g5]ally bett] subjects ?an adults4 ,z already not$1 cli5ts :o are m anxi\s t5d to accept hypnotic sugge/ion m readily4 ,cli5ts :o are motivat$ to *ange respond be/ to hypnotic sugge/ion4 ,individuals :o are imag9ative1 :o _h fictiti\s companions 9 *ildhood1 :o read a good deal1 & :o c become readily absorb$ 9 nature are incl9$ to make good subjects4 ,good rapport betwe5 cli5t & !rapi/ & a s5se ( tru/ 9 ! !rapi/'s goodwill & ability contribute greatly to successful hypno!rapy4 ,russian-born ,lewis ,r4 ,wolb]g 7#aije-aihh7 0 a lead+ ,new ,york hypno!rapi/ orig9ally tra9$ z a psy*oanaly/4 ,he is recogniz$ = ! compreh5siv5ess & eclecticism ( 8 approa*4 ,aft] =ty ye>s ( practice1 he came to see its ma9 limitation3 ,because hypnosis is s dramatic a ph5om5on1 x is easy to ov]e/imate its pot5tial4 ,a great _m ?+s may be accompli%$ ) a subject 9 a trance1 ev5 ! removal ( psy*ologically det]m9$ symptoms4444 ,b almo/ imm$iately aft] hypnosis has end$1 or %ortly !reaft]1 ! symptoms w return if ! subject has a psy*ological ne$ = !m4 italics add$ 444 ,q (t5 pati5ts on disability comp5sation are s5t to me by insurance companies = hypnotic exam9ation & treatm5t4 ,almo/ inv>iably1 ^! casualties cl+ to _! symptoms ) ! desp]ation ( a dr[n+ man hang+ on to a raft4444 ,!re are o!r second>y ga9s a p]son may get out ( hold+ onto 8 symptoms4 ,! ne$ to puni% himself = 8 guilt feel+s1 ! desire to ab&on an adult adju/m5t & #bbc return to ! protective blanket ( infancy 9 ord] to be tak5 c>e (4444 ,symptoms d n magically vani%2 !y mu/ be worn d[n4 ,x is ess5tial to replace !m ) productive habits4#h #h ,wolb]g1 ,hypnosis1 pp4 #bcg-bci4 ,,m$itation ,= individuals :o are able to make a long-range commitm5t to ! practice ( a discipl9e t1 ov] a p]iod ( _m mon?s & ye>s1 c /r5g!n !m & help !m to become m fully integrat$ & c5t]$4 _/99 ,don't g outside y\rself1 return into y\rself4 ,! dwell+ place ( tru? is ! inn] man4 ,sa9t ,augu/9e1 ,! ,true ,religion ,m$itation is a sy/ematic discipl9e t attempts to help p move t[>d ! goal ( self-realization4 ,x is n ! creation ( "o individual or gr\p4 ,te*niques ( m$itation h evolv$ ov] _m c5turies & 9 diff]5t p>ts ( ! _w4 ,& yet ^! te*niques be> /rik+ simil>ities to ea* o!r1 :e!r !y orig9at$ 9 ! temples & mona/]ies ( ,india1 ,japan1 ,europe1 or ! ,middle ,ea/4 ,m$itation is n a relax$ act ( contemplat+ "o's navel2 x m closely resembles a?letic tra9+4 ,x is a =m ( progressive m5tal ex]cise t has z its goal a /r5g!n+ ( a p]son's self-confid5ce1 inn] /r5g?1 & ! m9d's ability to focus & conc5trate4 ,m$itation takes consid]able endurance4 ,x is ess5tially a discipl9e4 ,x requires =titude1 p]sev]ance1 & a /rong w4 ,l a?letic ability1 skills 9 m$itation _c be develop$ )\t regul> practice4 ,because its effects are felt only gradually1 m$itation ne$s a long-t]m commitm5t to su/a9 x1 & ?is ultimately mu/ be bas$ on fai? 9 its ev5tual value4 ,! discipl9$ & regul> practice ( m$itation ov] a p]iod ( _m mon?s appe>s to lead to a s5se ( p]sonal integration1 a s5se ( be+ m firmly c5t]$ 9 y\rself1 #bbd m confid5t & aw>e ( y\r connection ) all t is4 ,exp]i5c$ practition]s ( m$itation claim to feel a great] degree ( p]sonal security2 !y feel m at ease ) !mselves4 ,!y claim to feel s]5ity1 ze/ 9 liv+1 & inn] peace & joy 9 "w1 :i* !y seem to be able to d m effici5tly1 ) great] en]gy & int]e/4 ,,:at ,,! ,,practice ,,( ,,m$itation ,,is ,,l ,te*niques ( m$itation %>e ! goal ( discipl9+ ! m9d to d "o ?+ at a "t4 ,until y h made a s]i\s attempt to m$itate1 y w v likely be unaw>e ( h[ p]petually di/ract$ y\r att5tion is4 ,we seldom make ! ef=t to /& ap>t f our ?\ghts1 to take note ( h[ num]\s & v>i$ !y are & h[ *aotically !y tumble into & out ( our consci\sness4 ,x is exce$+ly h>d "w to quiet ^! *att]+ monkeys ( ! m9d4 ,quiet+ ! ov]active & undiscipl9$ m9d is a *all5g+ task4 ,x takes en]gy & a great deal ( practice4 ,!re are _m approa*es to m$itation4 ,"h1 we w look at ?ree4#i #i ,see ! excell5t introduction to ! practice ( m$itation by ,lawr5ce ,le,shan1 ,h[ to ,m$itate3 ,a ,guide to ,self-,discov]y 7,bo/on3 ,little1 ,br[n ,co41 #aigd74 ,dr4 ,le,shan is a psy*o!rapi/ 9 ,new ,york ,city :o tea*es _m ( 8 cli5ts m$itation z "p ( _! !rapy4 ,brea? ,c\nt+ ,brea? c\nt+ is "o way to tra9 y\r m9d to control & focus att5tion4 ,! object is to be do+ "o ?+1 & "o ?+ only1 becom+ fully involv$ 9 t s+le purpose4 ,/>t by f9d+ a com=table position1 sitt+ or ly+ d[n4 ,place a clock or wat* :]e y c see x )\t hav+ to turn y\r head4 ,usually ) eyes clos$1 y !n beg9 to c\nt y\r brea?s1 sil5tly3 "o z y sl[ly exhale ! fir/ brea?1 two z y exhale ! second1 etc4 ,aft] y get to f\r />t ) "o aga94 ,! purpose is to be do+ only ?is1 only brea?+ & c\nt+4 ,y w quickly f9d t y\r m9d rebels2 x w /ray & w&] :5ev] y\r conc5tration & att5tion falt]4 ,x is a recalcitrant entity4 ,y w be do+ well 9 ! beg9n+ if y c succe$ = only a few seconds #bbe at a "t 9 be+ consci\s only ( y\r c\nt+4 ,di/ractions w subv]t y\r w 9 a split second4 ,y w f9d y\rself ?9k+ ( a ho/ ( ?+s3 :at to d tomorr[ morn+1 :e!r y are do+ well or badly at m$itation1 :e!r x is silly to be do+ ?is1 :at's = d9n]1 taxes1 "w1 or t it* on y\r =ehead4 ,aga9 & aga9 y w h to return y\r m9d to ! task at h&4 ,v quickly1 y'll beg9 to realize t m$itation is h>d "w4 ,x is fru/rat+ & dem&+4 ,practice do+ ?is = fifte5 m9utes a day4 ,aft] a few weeks1 increase to tw5ty m9utes4 ,aft] ano!r f\r weeks1 sp5d tw5ty-five to ?irty m9utes a day4 ,once y c d ?is1 cont9ue to practice daily = ano!r mon?4 ,x w take t long be=e y w beg9 to s5se :e!r ?is approa* to m$itation is go+ to be useful to y4 ,! ,m$itation ( ,contemplation ,?is is an alt]native approa* to m$itation4 ,aga91 ! purpose is to discipl9e y\r m9d by means ( focus$ att5tion4 ,9 ?is approa*1 y try to focus att5tion on a physical object4 ,pick a natural object--a %ell1 a small /one1 a press$ leaf4 ,n[1 ) ! object a foot or two f y1 simply look at x4 ,! purpose is to look at ! object actively1 to keep y\r att5tion fix$ on x1 b to be wakeful & al]t4 ,d n />e at "o place on ! object or /ra9 y\r eyes4 ,explore ! object1 look at x1 att5d to x4 ,z usual1 y'll f9d pl5ty to di/ract y--/iffness1 ! ne$ to move1 sleep9ess1 slipp+ into ?9k+ ab\t problems y ne$ to solve4 ,ea* "t y\r m9d drifts out ( track1 g5tly br+ y\r att5tion back to ! object4 ,try ?is = t5 m9utes a day = two weeks1 !n fifte5 m9utes a day = a mon?1 !n tw5ty m9utes = ! next mon?4 ,by !n1 y w "k if ?is approa* w help y4 ,be prep>$ = "s effective sessions & "s disc\rag+ ones4 ,rememb] t no "o said m$itation w\ld be easy4 ,! ,m$itation ( ! ,bubble ,?is is an anci5t =m ( m$itation t1 aga91 seeks to discipl9e ! m9d by develop+ y\r ability to focus on "o ?+ at a "t4 ,9 ?is m$itation1 y conc5trate on y\r own /ream ( consci\sness4 ,imag9e y\rself sitt+ quietly on ! bottom ( a cle> lake4 ,ea* ( y\r ?\ghts & feel+s =ms a bubble t sl[ly rises to ! surface ( ! lake4 ,z ea* #bbf comes to y\r m9d1 wat* x closely & ?9k only ( x = ! five seconds or s t x takes to rise to ! surface4 ,be aw>e ( ! sl[ rhy?m ( ! bubbles4 ,try to sp5d approximately equal am\nts ( "t att5d+ to ea* bubble4 ,if ! same ?\ght1 ! same bubble1 rises sev]al times1 ?is is ,,ok4 ,if y cont9ue1 ! repetition w pass4 ,if no?+ comes to m9d = a "t1 ?is1 too1 is ,,ok4 ,=m an empty bubble4 ,try ?is m$itation = t5 m9utes a day = two weeks1 !n increase to tw5ty m9utes a day = "o or two mon?s4 ,by !n1 y w "k if ?is approa* to m$itation is b5eficial to y4 ,,! ,,b5efits ,,( ,,m$itation ,h[ w y recognize :e!r an approa* to m$itation has value = y8 ,any *anges t occur 9 y w be gradual2 y mu/ be pati5t4 ,if1 aft] mo/ sessions ( m$itation1 y feel g5]ally m integrat$1 calm]1 m at ease1 ?is is a good sign4 ,ov] a p]iod ( "t1 if y are work+ h>d at an approa* to m$itation t seems to fit y\r temp]am5t1 ^! p]iods ( feel+ peaceful1 al]t1 & com=table 9 ! _w w gradually become m evid5t to y4 ,physiologically1 m$itation appe>s to lead to a deeply relax$ /ate ( al]t conc5tration4 ,y\r respiration & he>t rates sl[1 ! level ( lactate 9 ! blood 7associat$ ) t5sion & anxiety7 drops l[]1 & !re is an increase 9 sl[ alpha bra9 waves1 associat$ ) pr(\nd relaxation4 ,:at is important1 no matt] :at approa* to m$itation y try1 is to /ay ) t approa* long en\gh to det]m9e its pot5tial value = y4 ,do+ a m$itation once or a few times is l jogg+ once or twice3 y c't expect to d]ive any b5efit f ex]cis+ a c\ple ( times4 ,m$itation is ! practice & expression ( discipl9e2 decid+ to practice regul>ly & !n c>ry+ out y\r decision are j z important z ! approa* y take to m$itation4 #bbg #af ,,drug ,,& ,,nutrition ,,!rapies ,,drug ,,!rapy3 ,,balanc+ ,,emotions ,,) ,,*emi/ry ,(t5 especially helpful to p :o are emotionally v upset s t !y may beg9 to b5efit f psy*o!rapy4 ,dur+ ! pa/ ?irty ye>s1 bio*emi/ry & ph>macology h made _m important contributions to ! treatm5t ( m5tal & emotional disord]s4 ,!re is no "q t psy*otropic--lit]ally m9d-turn+ or m9d-influ5c+--drugs c help _m p dur+ p]iods ( emotional or m5tal suff]+4 ,psy*otropic drugs c be us$ by !mselves or 9 conjunction ) psy*o!rapy4 ,frequ5tly1 drugs are us$ to help r$uce ! sev]ity ( symptoms 9 pati5ts s t !y may b5efit f psy*o!rapy4 ,effective psy*o!rapy requires y to be comp>atively calm1 rational1 & able to make well-?\ght-out decisions4 ,^! ?+s are n possible if y are t]ribly agitat$1 are despond5t & cry+ mu* ( ! "t1 or #bbh may1 = example1 h di/urb+ halluc9ations & are no long] 9 t\* ) reality4 ,! aim ( drug !rapy is1 ev5tually1 to elim9ate ! ne$ = m$ication4 ,9 ?is respect1 psy*oph>macology is simil> to psy*o!rapy3 bo? w\ld l to help ! pati5t s t he or %e no long] ne$s ei!r "o4 ,x is n always possible to d ?is1 h[ev]4 ,"s disord]s are1 at pres5t anyway1 *ronic conditions4 ,p ) p>k9sonism or epilepsy may h to take m$ication indef9itely4 ,b ! g5]al tr5d is to use psy*otropic drugs z tempor>y measures to br+ symptoms quickly "u control s t psy*o!rapy c be />t$4 ,! only pr(essionals :o are legally au?oriz$ to prescribe psy*otropic drugs are physicians &1 9 p>ticul>1 psy*iatri/s4 ,h[ev]1 psy*o!rapi/s are n[ be+ tra9$ to be s5sitive to conditions t may h an organic basis4 ,c]ta9ly1 x is wise to h a ?or\gh physical exam to rule out organic problems t c cause emotional or m5tal upset 7see ,*apt] #h74 ,num]\s /udies h %[n t up to half ( ! individuals :o are ref]r$ to a psy*o!rapi/ h undiagnos$ organic problems4#a ,?is is an important caution to be> 9 m9d4 #a ,see1 = example1 ,l4 ,small1 ,neuropsy*odiagnosis 9 ,psy*o!rapy 7,new ,york3 ,brunn]_/,mazel1 #aihj74 ,,types ,,( ,,psy*otropic ,,drugs ,!re are n9e ma9 classes ( psy*otropic drugs3 ,antianxiety1 or ,anxiolytic1 ,drugs ,^! are ! s-call$ m9or tranquiliz]s4 ,!y are s$atives = ! wak+ h\rs t are prescrib$ = p :o h excessive t5sion & anxiety4 ,neuroleptics1 or ,antipsy*otics ,psy*osis is a disord] t impairs a p]son's abilities to ?9k1 rememb]1 communicate1 respond ) appropriate emotions1 & int]pret reality )\t great di/ortion4 ,p :o h ^! difficulties c (t5 be treat$ effectively ) neuroleptic or antipsy*otic drugs1 also kn[n z ! major tranquiliz]s1 :i* h specific effects on ! bra9's activity4 #bbi ,s$ative-,hypnotic ,drugs ,^! drugs act z s$atives at l[ doses & produce a hypnotic action at high] doses4 7,! ^w hypnotic z us$ by ph>macologi/s does n ref] to a hypnotic trance b means simply t a drug causes dr[s9ess & r$uces motor activity47 ,9 ev5 l>g] doses1 ^! drugs act z ane/hetics4 ,antianxiety drugs1 ! m9or tranquiliz]s1 c be gr\p$ ) ^! drugs because ( _! s$ative effect4 ,antidepressants ,^! drugs are us$ prim>ily to treat :at psy*iatri/s call endog5\s depression--t is1 major1 incapacitat+ depression t is n associat$ ) an outside ev5t or situation4 ,depressions t occur aft] ! loss ( a job1 ! dea? ( someone close1 or "s o!r ext]nal ev5t are call$ exog5\s depressions4 ,!y c sometimes be treat$ effectively ) antidepressants1 b drug !rapy = situation-induc$ depression g5]ally is less successful4 ,li?ium !rapy is a specific treatm5t prim>ily = manic-depressive disord]s4 ,li?ium c>bonate is a naturally occurr+ m9]al salt4 ,= manic-depressive pati5ts--) wide sw+s ( mood f feel+ extremely en]getic & emotionally high to feel+ s]i\sly depress$--li?ium !rapy may (f] help z a mood /abiliz]4 ,/imulants ,caffe9e & nicot9e are ! be/ kn[n ( ! /imulants4 ,9 !rapy1 /imulants are us$ 9 ! treatm5t ( n>colepsy 7individuals sudd5ly fall asleep = %ort p]iods ( "t1 ev5 :5 engag$ 9 activities71 "s =ms ( epilepsy1 &1 p>adoxically1 hyp]k9etic *ildr5 7:o are excessively active & h %ort att5tion spans & explosive irritability74 ,antiepileptic ,drugs ,= _m ( ! two million ,am]icans ) epilepsy1 ^! antiseizure drugs are v helpful4 ,epilepsy does n t5d to %ort5 an individual's life1 b x is a sev]e1 tr\bl+1 & (t5 disabl+ condition = :i* drug !rapy c be a bless+4 ,antip>k9sonian ,drugs ,^! drugs h help$ ! lives ( _m p :o are #bcj affect$ by ! *>act]i/ic involunt>y tremors ( ?is disease1 :i* c cause abnormalities 9 gait & trembl+ ( ! volunt>y muscles4 ,psy*$elics ,psy*$elic drugs are also call$ halluc9og5s4 ,!y produce alt]$ /ates ( consci\sness & s5sory di/ortions4 ,psy*$elics h no e/abli%$ use 9 psy*iatry at pres5t 9 ! ,unit$ ,/ates4 ,great ,brita9 & ,canada1 h[ev]1 h exp]im5t$ ) psy*$elics 9 ! treatm5t ( alcoholics1 :om !y sometimes appe> to help4 ,psy*$elics h also sometimes be5 us$ = ! t]m9ally ill & 9 c]ta9 cases ( autism4 ,drugs = ,heada*e1 ,migra9e1 & ,neuralgia ,drugs = ^! common k9ds ( pa9 are widespread4 ,migra9es 7:i* may cause blurr$ vision1 v]tigo1 & ev5 tempor>y deafness7 & clu/] heada*es 7:i* cause sev]e pa9 ar\nd ! eyes1 te>+ & r$d5+ ( ! eyes1 & runny nose7 frequ5tly c be treat$ successfully ) specific drugs4 ,neuralgias are recurr5t knifelike facial & head pa9s t c la/ = days & ev5 mon?s4 ,!y c be difficult to treat successfully4 ,,:at ,,drug ,,!rapy ,,is ,,l ,9 ?is section1 we'll look at "s ( ! ma9 emotional & m5tal symptoms t are (t5 help$ by means ( drug !rapy4 ,s9ce all m$ications h pot5tial side effects1 we w look at ^! z well4 ,anxiety ,excessive anxiety causes v unpleasant symptoms3 dizz9ess or light-head$ness1 sweat+1 p\nd+ he>t1 vomit+1 di>rhea1 %ak+1 muscle t5sion1 inability to sleep4 ,_m ( ^! symptoms c be controll$ by antianxiety drugs4 ,all ( ^! drugs c lead to psy*ological dep5d5ce :5 !y are us$ regul>ly ov] p]iods ( "t t v>y ) ! p]son & ! m$ication4 ,= ?is reason1 !y are normally us$ = %ort p]iods1 (t5 at ! beg9n+ ( psy*o!rapy4 #bca ,! mo/ commonly prescrib$ antianxiety drugs include ^! 7trade names73 ,at>ax ,ativan ,c5trax ,clonop9 ,dalmane ,dorid5 ,equanil ,librium ,loxitane ,paxipam ,re/oril ,s]ax ,tranx5e ,tybatran ,valium ,valmid ,xanax ,al?\gh relatively small p]c5tages ( pati5ts exp]i5ce !m1 z ) mo/ drugs1 !re may be side effects1 includ+ dr[s9ess1 impair$ judgm5t & p]=mance1 nausea_/vomit+1 ataxia 7loss ( volunt>y muscle coord9ation71 & agitation 7p>adoxical re/lessness74 ,pati5ts :o h tak5 an antianxiety drug = a p]iod ( "t are (t5 in/ruct$ to r$uce _! dosage gradually to avoid mild1 infrequ5tly sev]e1 )drawal symptoms4 ,antianxiety drugs c r$uce agitation & produce a relative s5se ( calm4 ,b1 un=tunately1 pati5ts usually develop a tol]ance to any antianxiety drug aft] ?ree to f\r mon?s1 & !n ! drug loses its effectiv5ess4 ,antianxiety drugs are usually limit$1 !n1 to %ort-t]m treatm5t4 ,long-t]m recov]y f ! symptoms ( anxiety is ! task ( psy*o!rapy3 to help cli5ts *ange _! attitudes1 behavior1 or way ( life4 ,depression ,depression c be a s]i\sly incapacitat+ emotional disord]4 ,depression c range f a l+]+ s5se ( sadness or grief to a feel+ ( utt] hopelessness1 guilt1 despond5cy1 uncontrollable cry+1 & suicidal ?\ghts4 ,! foll[+ symptoms are typical3 insomnia or e>ly wak+1 loss ( appetite & loss ( int]e/ 9 sex1 inability to conc5trate1 great difficulty 9 mak+ decisions1 & a r$uc$ desire & ability to assume job & family responsibilities4 ,?\gh depression is call$ ! common cold ( emotional illness1 x is n to be tak5 lightly1 s9ce sev]e depression is life-?reat5+1 z _m #bcb suicides te/ify4 ,depression affects "o out ( five p dur+ _! lifetimes2 m wom5 suff] f depression ?an m54 ,at ! "t ( ?is writ+1#b ! mo/ widely prescrib$ antidepressants are ! tricyclics4 ,!y are mo/ effective 9 treat+ endog5\s depressions2 ,,mao inhibitors 7see bel[7 are m useful 9 cases ( atypical depression1 :i* frequ5tly is associat$ ) a situation ! pati5t _c come to t]ms )1 su* z ! loss ( a job or ( a lov$ "o4 #b ,s9ce ?is book 0 publi%$1 ,s,s,r,is or selective seroton9 reuptake inhibitors1 h become ! mo/ commonly prescrib$ antidepressant m$ication 9 ! ,u4,s & _m o!r c\ntries4 ,= read]s int]e/$ 9 m in=mation ab\t ,s,s,r,is1 see ,wikip$ia's article1 http3_/_/en4wikip$ia4org_/wiki_/,selecti ve-s]oton9-reuptake-inhibitor4 ,tricyclic antidepressants include ^! 7trade names73 ,av5yl ,elavil ,norpram9 ,pamelor ,s9equan ,surmontil ,t(ranil ,vivactil ,approximately #gj p]c5t ( pati5ts :o take tricyclics improve4 ,sev]al new] drugs--! tetracyclics1 dib5zoxap9es1 & triazolopyrid5es--are simil> to ! tricyclics 9 _! effects4 ,!y include ^! 7trade names73 ,as$9 ,desyrel ,ludiomil ,if tricyclics d n help1 ,,mao inhibitors 7monoam9e oxidase inhibitors7 are usually tri$4 ,,mao inhibitors mu/ be us$ ) great caution because !y c int]act ) c]ta9 foods1 bev]ages1 or drugs to produce sev]e high blood pressure4 ,_m foods & bev]ages are prep>$ by f]m5tation processes2 e4g41 *eese1 an*ovies1 pickl$ h]r+1 pa/rami1 olives1 be]1 & w9e1 all ( :i* pati5ts :o take ,,mao inhibitors mu/ avoid4 ,^! foods & bev]ages conta9 a *emical comp\nd1 an am9e call$ tyram9e1 :i* c cause dang]\sly high blood pressure1 a hyp]t5sive crisis1 9 p tak+ an ,,mao inhibitor4 ,fur!rmore1 ,,mao inhibitors _c be tak5 ) antihi/am9es2 pati5ts :o take ,,mao inhibitors may be w>n$ to avoid o!r drug int]actions4 ,^! w>n+s %\ld be tak5 s]i\sly because ,,mao inhibitors are "o ( ! mo/ pot5tially toxic gr\ps ( psy*oactive drugs4 ,yet !y c make ! diff]5ce betwe5 night & day = _m cases ( depression4 #bcc ,!re are common side effects caus$ by all ! antidepressants we've m5tion$1 includ+ an uncom=tably dry m\?1 dizz9ess1 especially :5 /&+ up quickly1 heada*es1 difficulty 9 ur9at+1 nausea_/vomit+1 con/ipation or di>rhea1 impot5ce1 inability to rea* orgasm1 agitation_/%ak+1 & rapid he>tbeat4 ,"s ( ^! side effects c be annoy+ b w (t5 dim9i% or disappe> once ! pati5t becomes accu/om$ to ! m$ication4 ,:5 side effects are n tol]able1 ! physician or psy*iatri/ w usually prescribe a diff]5t antidepressant t may h few]1 or no1 side effects = a giv5 pati5t4 ,"o ( ! drawbacks ( antidepressants is t !re is a wait+ p]iod ( days or weeks be=e physician & pati5t "k :e!r a p>ticul> drug is go+ to help4 ,if1 aft] f\r to six weeks1 an antidepressant has n r$uc$ a pati5t's depression1 !n a second drug may be tri$1 &1 aga91 !re w be a delay ( days or weeks be=e x is cle> :e!r ! m$ication is go+ to "w4 ,"o ne$$ area ( rese>* 9 psy*oph>macology is to devise te/s t w help to tell a doctor :at antidepressant is mo/ likely to be effective = ! individual pati5t4 ,at pres5t1 ?\gh "s g5]al guidel9es exi/1 mat*+ pati5t ) an effective & tol]able m$ication is a process ( intellig5t trial & error4 ,li?ium has be5 us$ to treat manic depression s9ce #aied4 ,li?ium is absorb$ quickly f ! ga/ro9te/9al tract1 b x acts sl[ly1 s x also takes "t to "k if x is go+ to be ( value4 ,blood levels ( li?ium ne$ to be *eck$ once or twice a week dur+ ! fir/ mon?1 twice a mon? = ! next mon? or two1 & !n once e "o to two mon?s4 ,li?ium is sometimes helpful 9 treat+ *ronic simple depression1 t is1 depression t is n associat$ ) p]iodic highs4 ,unlike mo/ drugs us$ 9 psy*iatry1 li?ium usually has few noticeable side effects & does n t5d to produce a feel+ ( s$ation or /imulation4 ,:5 side effects occur1 x is usually because ! li?ium level 9 ! blood has become excessive4 ,side effects !n c include vomit+1 lack ( coord9ation1 muscul> weakness1 or dr[s9ess4 ,9 addition to antidepressant drugs1 electroconvulsive !rapy 7,,ect7 is sometimes us$ to treat sev]e depression1 z x is to treat "s o!r conditions1 includ+ s*izophr5ia4 ,al?\gh ,,ect is n itself a =m ( drug !rapy1 x is important to #bcd m5tion x "h s9ce x is "o ( ! ma9 m$ical treatm5ts 7z oppos$ to ! talk !rapies ( psy*o!rapy7 us$ by psy*iatry today4 ,,ect is adm9i/]$ aft] a pati5t has be5 s$at$ & giv5 a g5]al ane/hetic4 ,! ma9 advantage ( ,,ect is t x acts mu* fa/] ?an any ( ! antidepressants4 ,= a s]i\sly suicidal pati5t1 ?is c be important4 ,! ma9 disadvantages ( ,,ect are t x c cause tempor>y memory loss1 tempor>y disori5tation & confusion aft] treatm5t1 & possible p]man5t *anges 9 bra9 function--reg>d$ by _m psy*iatri/s z subtle1 i4e41 fairly m9or4 ,ano!r disc\rag+ f9d+ is t depression recurs aft] ,,ect 9 _m pati5ts--9 up to #df p]c5t )9 six mon?s aft] ,,ect4 ,,ect has receiv$ poor press4 ,z n[ adm9i/]$1 ! actual treatm5t is pa9less4 ,x is1 nev]!less1 a =ceful1 invasive approa*1 s _m psy*iatri/s pref] n to use x if m$ication c be successful4 ,z m bio*emical me?ods ( treatm5t are discov]$1 ,,ect v likely w be us$ less & less4 ,psy*osis ,psy*osis is ! mo/ s]i\s & incapacitat+ degree ( m5tal illness4 ,emotional problems ) symptoms ( anxiety or depression1 or bo? toge!r1 are call$ affective disord]s4 ,p :o h affective disord]s make up ! majority ( cli5ts se5 by mo/ psy*o!rapi/s2 ^! cli5ts are n out ( t\* ) reality4 ,! problems t !y h--?\gh pa9ful & sometimes ob/acles to normal liv+--are ess5tially diff]5t f ! difficulties t pati5ts ) psy*oses h4 ,?\gh !re is no unanimity ab\t ?is among heal? c>e pr(essionals1 we w di/+ui% betwe5 ^! two k9ds ( problems by call+ a psy*osis a m5tal illness1 z oppos$ to an emotional disord]4 ,x is a matt] n only ( degree b ( k9d4 ,a p]son :o is sev]ely depress$ or extremely anxi\s is usually /ill able to communicate rationally1 & di/+ui% :at is real f :at is fantasy or delusion4 ,psy*oses1 on ! o!r h&1 are disord]s t impair a p]son's abilities to ?9k1 rememb]1 communicate1 respond ) appropriate emotions1 int]pret reality coh]5tly1 & behave 9 a reasonably normal way4 ,p ) psy*oses #bce (t5 h difficulty controll+ _! impulses1 & _! moods may *ange quickly & radically4 ,psy*otic individuals (t5 believe ?+s to be true t are n1 & !y may he> s\nds or voices t are n !re4 ,!re are _m !ories ab\t ! causes ( psy*osis4 ,rec5tly1 rese>* /udies 9 psy*iatry h %[n t psy*osis may be due to an excess ( c]ta9 *emical sub/ances call$ neurotransmitt]s 7su* z norep9ephr9e or dopam9e7 9 ! bra94 ,ano!r !ory is t ! bra9 ( a psy*otic p]son may be excessively s5sitive to ! action ( c]ta9 neurotransmitt]s4 ,! antipsy*otic drugs1 or neuroleptics1 r$uce ! bra9's s5sitivity to "o or m ( ^! *emical sub/ances4 ,"s ( ! be/-kn[n antipsy*otic drugs are ^! 7trade names73 ,compaz9e ,haldol ,mell>il ,prolix9 ,/elaz9e ,?oraz9e ,trilafon ,vespr9 ,antipsy*otic drugs frequ5tly c cle> ?\ght processes1 r$uce or end halluc9ations1 relieve agitation & anxiety1 & g5]ally help pati5ts return to ! _w ( reality1 communicate ) o!rs1 & behave 9 a m reasonable & /able way4 ,antipsy*otic drugs h _m possible side effects4 ,!y may produce dr[s9ess1 dizz9ess & nausea1 fa9t+1 muscle tremors1 a %uffl+ gait1 blurr$ vision1 insomnia1 s5sitivity ( ! sk9 to sunlight1 & o!r effects4 ,p>ticul>ly di/urb+ side effects c (t5 be avoid$ by *ang+ to a diff]5t m$ication4 ,"s p ) psy*otic symptoms may ne$ to take antipsy*otic m$ication = only a few weeks or mon?s4 ,recurr5t or *ronic illnesses1 h[ev]1 may require drug treatm5t ov] a long p]iod4 ,,:5 ,,drug ,,!rapy ,,is ,,appropriate ,s9ce psy*otropic drugs c be prescrib$ only by a physician or psy*iatri/1 8 or h] judgm5t w det]m9e :e!r a pati5t's difficulties seem to l5d !mselves to drug !rapy4 ,9 cases involv+ s]i\s anxiety1 depression1 or psy*osis1 x is #bcf r\t9e to expect drug !rapy to be us$1 (t5 9 conjunction ) psy*o!rapy4 ,z we not$ e>li]1 x is ! hope ( drug !rapy t x w be ne$$ only tempor>ily1 b "s *ronic or p]iodically recurr+ conditions may be be/ treat$ by cont9u$ m$ication = a numb] ( ye>s4 ,s9ce _m ( ! psy*otropic drugs are new1 x is n kn[n :e!r long-t]m use by "s pati5ts may ultimately affect _! heal? adv]sely4 ,unless we decide to d )\t m$ication t c be a bless+ 9 reliev+ great suff]+1 until long-t]m /udies c be complet$1 ! pot5tial risks are !re4 ,x is a matt] ( weigh+ alt]natives3 on ! "o h&1 p]haps incapacitat+ emotional or m5tal di/ress1 & on ! o!r1 side effects t _c be fully pr$ict$4 ,,!rapy ,,?r\gh ,,nutrition ,!re is no "q t nutritional defici5cies c influ5ce ! function+ ( ! bra9 & affect ! p]sonality4 ,!re are cle>-cut cases1 = example1 ( vitam9 defici5cies t result 9 symptoms ( psy*ological di/urbance4 ,! majority ( ^! cases involve p :o suff] f v evid5t malnutrition4 ,un=tunately1 ! connection betwe5 nutrition & m5tal heal? is /ill vague2 bio*emi/s are becom+ m aw>e ( ! ne$ to take into acc\nt individual v>iations4 ,x is n always possible to specify exactly h[ mu* ( a m9]al1 a vitam91 or an am9o acid a p]son requires = good heal?4 ,"s p1 = _m diff]5t reasons1 _c effectively utilize ! food !y eat4 ,o!rs h all]gic reactions to c]ta9 foods2 "s all]gic reactions appe> to be subtle1 affect+ a p]son's moods4 ,/ill o!r p seem to be especially s5sitive to only mod]ate *anges 9 _! blood sug> levels4 ,we h a great deal 9 common z biological organisms4 ,yet our bio*emi/ries may be f9ely tun$ 9 individual ways t w\ld require a detail$ & sophi/icat$ und]/&+ ( an imm5se numb] ( int]relat$ factors t boggle ! m9d 9 complexity4 ,psy*onutrition has a long road to foll[ be=e x w be a sci5ce4 ,s-call$ holi/ic or or?omolecul> 7! "r molecule7 physicians & psy*iatri/s attempt to take individual v>iations & s5sitivities into acc\nt4 ,! ne$ to d ?is may be ess5tial 9 _m cases1 b dep5dable & exact me?ods ( #bcg evaluation & treatm5t simply d n exi/ z yet4 ,except 9 cases ( outright malnutrition1 f9d+ connections betwe5 nutrition & emotional heal? is /ill an art4 ,"s or?omolecul> psy*iatri/s appe> to h be5 dramatically successful 9 help+ "s pati5ts ) c]ta9 m5tal or emotional problems4 ,b because psy*onutrition is /ill a bord]l9e discipl9e1 x is an area :]e controv]sies ab\nd & results are (t5 op5 to "q4 ,_m physical conditions c be influ5c$ greatly by nutrition4 ,among ^! are ! metabolic disord]s diabetes & hypoglycemia1 bo? ( :i* c affect a p]son's emotional life 7see ,*apt] #h74 ,9 addition1 relation%ips h rec5tly be5 discov]$ betwe5 l[]$ blood pressure1 r$uc$ *ole/]ol & triglyc]ide levels1 & a diet high 9 fib]4 ,a ?iam9e 7vitam9 ,b#a7 defici5cy--:i* causes pellagra1 a *ronic disease t leads to sk9 lesions & ga/ro9te/9al di/ress--c produce depression1 mania1 & p>anoia4 ,ano!r example is p]nici\s anemia1 9 l>ge "p due to vitam9 ,b#ab %ortage1 :i* c cause mood9ess1 difficulty 9 rememb]+ & conc5trat+1 viol5t behavior1 depression1 & halluc9ations4 ,b ! fact t _m physical disord]s1 "s ( :i* c cause psy*ological di/urbances1 are treatable 9 "p ?r\gh nutrition does n1 un=tunately1 imply t emotional disord]s 9 g5]al c be treat$ by means ( diet4 ,?is may be ! case = "s individuals = :om special diets c influ5ce a specific bio*emical imbalance4 ,b rese>* is j beg9n+ to develop te/s t c detect ^! s5sitive individual v>iations4 ,once !y c be id5tifi$ a m difficult /ep has to be made3 to det]m9e h[ ?is in=mation c be us$ to select an effective treatm5t4 ,nutritioni/s & physicians agree t good physical & m5tal heal? dep5d on a comb9ation ( prop] body weight1 adequate ex]cise1 good diet1 & decreas$ /ress4 ,b beyond ?is1 an emotionally di/urb$ p]son :o seeks help ?r\gh diet>y !rapy--= example1 ?r\gh megavitam9 doses--%\ld realize t he or %e is really involv$ 9 self-exp]im5tation4 ,"s or?omolecul> psy*iatri/s may be v tal5t$ 9 treat+ "s ( _! pati5ts4 ,^! pati5ts are v =tunate2 x is h>d to avoid say+ !y are lucky4 ,! ma9 problem t faces ?is new area ( psy*onutrition is "o ( g5]al reliability & cr$ibility4 #bci ,,"p ,,iii ,,important ,,que/ions #bda #ag ,,locat+ ,a ,,!rapi/ ,am]ica is ov]cr[d$ ) help]s2 !re are s _m helpful p out !re1 !y are lit]ally bump+ into ea* o!r1 & mu/ be regulat$ by laws & organizations to keep !m f help+ s mu* t ! av]age cli5t 9 ne$ ( help isn't torn to %r$s4 ,paul ,g4 ,qu9nett1 ,! ,tr\bl$ ,p ,book ,?is *apt] assumes t y h us$ "o ( ! two me?ods describ$ 9 ,*apt] #g1 ,self-,diagnosis3 ,mapp+ ,y\r ,way to a ,!rapy1 & h n[ *os5 an approa* to !rapy t seems mo/ promis+ 9 relation to y\r goals or problems & y\r p]sonality4 ,y n[ face ! practical problem ( h[ to locate a !rapi/ ) ! pr(essional exp]tise to (f] y ! k9d ( help y desire4 ,!re are ?ree factors t y ne$ to take into acc\nt 9 ord] to f9d a suitable !rapi/3 #a4 ! degree ( s]i\sness ( y\r problem or ne$ #b4 any f9ancial limitations y may h #c4 ! res\rces available :]e y live 7or h[ f> y are will+ to travel if y _c locate ! help y want 9 y\r area7 #bdb ,! s]i\sness ( y\r problem or ne$ may fall into "o ( ?ree g5]al categories3 ,v urg5t ne$3 ,y are sev]ely upset1 p]haps suicidal or dang]\s to o!rs4 ,or1 y are suff]+ f extreme *anges ( mood or p]sonality1 major depression1 delusions1 or halluc9ations4 ,9 ei!r ( ^! cases1 y %\ld see a pr(essional imm$iately4 ,y or a fri5d or relative %\ld contact y\r family physician = a ref]ral to a psy*iatri/ or call a crisis int]v5tion c5t] = a ref]ral to a psy*iatri/4 7,crisis int]v5tion c5t]s1 sometimes call$ suicide prev5tion c5t]s or crisis hot l9es are li/$ among ! em]g5cy numb]s on ! inside front page ( y\r ,:ite ,pages directory2 o!rwise1 dial #iaa = assi/ance47 ,s]i\s p]sonal1 m>ital1 or family problems or goals3 ,y1 y & y\r sp\se1 or memb]s ( y\r family ne$ help soon b c wait = an appo9tm5t1 if necess>y1 = a numb] ( weeks4 ,mod]ate ne$3 ,!re is no urg5cy4 ,y are int]e/$1 be=e y consid] =mal !rapy1 9 explor+ "s alt]natives--p]haps by talk+ ) a m9i/]1 prie/1 or rabbi or by try+ "o ( ! adjunctive approa*es to !rapy 7su* z !rapeutic ex]cise1 m$itation1 relaxation tra9+7 on its own1 )\t individual !rapy4 ,?is *apt] is int5d$ prim>ily = p 9 ! well-populat$ middle category1 p :o h s]i\s problems or goals & are able to weigh alt]natives c>efully & )\t extreme pressure4 ,! s]i\sness ( ! problem & ! co/ ( treatm5t g h& 9 h&4 ,! range ( treatm5t alt]natives is %[n 9 ! table bel[4 ,condition ,co/ ,treatm5t by3 ---------------------------------------- ----------------------------- m s]i\s m exp5sive ,psy*iatri/s ,psy*ologi/s ,social "w c\nselors ,adjunctive !rapi/s3 bi(e$back1 bio5]getics1 ex]cise1 m$itation1 etc4 ,religi\s c\nselors less s]i\s less exp5sive ,self-help #bdc ,9 g5]al1 ! less s]i\s ! problem1 ! l[] ! pot5tial co/ ( treatm5t4 ,also1 ! m s]i\s ! condition1 ! m advisable x is to h at lea/ a prelim9>y evaluation by a psy*iatri/4 ,simil>ly1 ! sett+s )9 :i* !rapy is available v>y widely3 ,condition ,co/ ,sett+3 ---------------------------------------- ----------------------------- m s]i\s m exp5sive ,hospitals ,resid5tial treatm5t c5t]s ,private practice ,ag5cies3 private1 /ate1 c\nty ,academic s\rces3 individual c\nsel+ = enroll$ /ud5ts vocational guidance c\nsel+ classes or work%ops adult ext5sion or cont9u+ education less s]i\s less exp5sive programs ,,f9d+ ,a ,,!rapi/ ,,) ,a ,,p>ticul> ,,specialization ,dur+ a "t ( increas+ specialization 9 heal? c>e1 _m psy*o!rapi/s h un=tunately be5 attract$ to eclecticism--t is1 kn[+ a reasonable am\nt ab\t a numb] ( diff]5t =ms ( !rapy1 b resi/+ specialization 9 any "o ( !m4 ,= "s individuals1 especially p int]e/$ 9 wide-spectrum gr[? & p]sonal developm5t1 an eclectic !rapi/ c be v b5eficial4 ,eclectic !rapi/s believe t !y are able to br+ a wid] scope ( und]/&+ to be> on a problem & a m flexible outlook4 ,if y h fairly well-def9$ ne$s & int]e/s1 h[ev]1 eclecticism makes x difficult to locate a !rapi/ :o has =mal tra9+ & ext5sive exp]i5ce specifically 9 treat+1 = example1 depression1 alcoholism1 family conflicts1 or adju/m5t problems4 ,no !rapi/ today c be an exp]t 9 ! :ole range ( human #bdd emotional problems & 9 ! _m specializ$ te*niques t h be5 develop$ to help4 ,,ref]rals ,!re are a numb] ( ways ( go+ ab\t locat+ a !rapi/4 ,y c />t by ask+ = a recomm5dation f any ( ^! s\rces3 99 y\r family doctor1 :o w mo/ likely sugge/ a colleague1 ano!r ,m4,d41 a psy*iatri/ 99 y\r m9i/]1 prie/1 or rabbi1 :o aga9 w sugge/ someone he or %e happ5s to "k or to h he>d ( 99 p]sonal fri5ds 99 ref]ral s]vices ,all ( ^! alt]natives are1 h[ev]1 limit$ by ! scope ( acqua9tance ( ! p]son or s]vice y h gone to4 ,ref]ral s]vices commonly are run by gr\ps ( subscrib+ psy*ologi/s 7or social work]s71 s if y call "o1 y w be ref]r$ to a p>ticipat+ psy*ologi/ 7or social work]74 ,sometimes ref]ral s]vices 7:i* usually *>ge no?+ = _! ref]rals1 unless y reque/ a prelim9>y consultation7 ma9ta9 a li/+ ( ! areas ( specialization ( _! pr(essional memb]s1 & ?is in=mation c be helpful4 ,if y h a specific approa* to !rapy 9 m9d & want to f9d a !rapi/ ) /rong cr$5tials 9 t approa*1 !re are two usually m promis+ roads to foll[3 ,,by ,,mail1 ,,or ,e-,,mail 7,,google ,,any ,,( ,,! ,,names ,,( ,,organizations ,,t ,,foll[73 ,fir/1 dep5d+ on y\r own judgm5t ( ! s]i\sness ( y\r problems or goals & ! ext5t to :i* ! co/ ( treatm5t is important to y1 y c reque/ a li/ ( !rapi/s 9 y\r area f ^! organizations3 ,am]ican ,psy*iatric ,association #adjj ,k ,/41 ,,nw ,wa%+ton1 ,,dc #bjjje ,canadian ,psy*iatric ,association #bbe ,lisg> ,/41 #ajc ,ottawa1 ,,on ,k#b,p #j;,c#f 7= psy*iatri/s7 #bde ,am]ican ,psy*ological ,association #abjj #ag? ,/41 ,,nw ,wa%+ton1 ,,dc #bjjcf ,canadian ,psy*ological ,association #eeh ,k+ ,edw>d ,ave4 ,ottawa1 ,,on ,k#a,n #g,n#f 7= psy*ologi/s7 ,national ,association ( ,social ,work]s #giha ,ea/]n ,ave4 ,silv] ,spr+1 ,,ma #bjijg ,canadian ,association ( ,social ,work]s #ee ,p>kdale ,ave41 #cl#f ,ottawa1 ,,on ,k#a,y #a;,e#e ,corporation ,pr(essionnelle des ,travailleurs ,sociaux du ,quebec #egeg ,decelles ,ave41 ,*4 #cce ,montreal1 ,,qc ,h#c,s #b;,c#c 7= social "w c\nselors7 ,ask = a li/ t %[s _! specialties4 ,if none is available1 ask = ! address ( ! bran* (fice ne>e/ y1 :i* y !n c contact = ?is in=mation4 ,if writ+ by mail1 be sure to enclose a /amp$1 self-address$ envelope to ensure a response4 ,,by ,,telephone ,a second way to locate a !rapi/ ) specialization 9 a p>ticul> area is ?r\gh c>eful use ( y\r telephone directory4 ,?is may take y "s "t1 & also "s prelim9>y calls1 b x c give y a good deal ( in=mation3 ,psy*iatri/s ,psy*iatri/s are li/$ 9 ! ,yell[ ,pages "u ,physicians & ,surgeons4 ,9 l>g] metropolitan directories1 y w usually f9d sep>ate head+s aft] ! g5]al li/+1 accord+ to specialties4 ,look !re = ,physicians-,psy*iatri/s or simil> head+4 ,_m psy*iatri/s today w li/ _! special focus !re--= example1 psy*oanalysis1 psy*oanalytic psy*o!rapy 7brief analysis71 m>riage & family !rapy1 hypnosis1 *emical dep5d5cy treatm5t1 *ild & adolesc5t !rapy4 ,if y want to see a psy*iatri/ & d n f9d "o :o indicates ! specializ$ approa* y want to try1 !n y w ne$ to make "s calls4 ,mo/ psy*iatri/s' secret>ies or receptioni/s are happy to tell #bdf y :at ! doctor specializes 94 ,if ! li/ ( 8 or h] areas ( specialization is impressively & ov]ly long1 p]haps x is be/ to look else:]e = a m reali/ic pr(essional4 ,if1 aft] locat+ a psy*iatri/ ) ! backgr\nd y are look+ =1 y want to d\ble-*eck 8 or h] cr$5tials1 ask ! secret>y if ! psy*iatri/ is a memb] ( ! ,am]ican ,psy*iatric ,association 7or1 if 9 ,canada1 ! ,canadian ,psy*iatric ,association71 :e!r he or %e complet$ a program ( /udy at an in/itute ( psy*o!rapy or psy*oanalysis1 & :e!r he or %e is bo>d c]tifi$4 7,rememb]1 any ,m4,d4 c call himself or h]self a psy*iatri/1 b n all h ! full qualifications ( a c]tifi$ psy*iatri/47 ,cl9ical ,psy*ologi/s ,cl9ical psy*ologi/s are li/$ 9 ! ,yell[ ,pages "u ,psy*ologi/s4 ,_! specialties are (t5 id5tifi$--e4g41 m>riage & family !rapy1 gr\p !rapy1 b]eavem5t1 alcoholism1 eat+ disord]s & addiction1 psy*ological assessm5t 7te/+71 le>n+ disord]s1 sexual dysfunction1 depression1 panic syndrome4 ,aga91 if ! li/ bel[ a giv5 psy*ologi/'s "n is unreasonably long1 y may h come across ei!r a g5ius or someone :o favors adv]tis+4 ,psy*ologi/s less (t5 m5tion ! p>ticul> approa* to !rapy !y use1 b "s d2 = example1 behavior !rapy1 ,ge/alt1 hypnosis1 or analytical approa* may be li/$4 ,aga91 x w probably be necess>y to make a few telephone calls4 ,if1 aft] locat+ a psy*ologi/ ) ! backgr\nd y are look+ =1 y want to d\ble-*eck 8 or h] cr$5tials1 y c frequ5tly f9d a copy 9 y\r public libr>y ( ! ,national ,regi/] ( ,heal? ,s]vices ,provid]s or1 9 ,canada1 ei!r ! ,canadian ,regi/ry ( ,heal? ,s]vice ,provid]s 9 ,psy*ology or ! ,int]national ,directory ( ,psy*ologi/s4 ,!y li/ lic5s$ psy*ologi/s ) ,ph4,d4s :o h complet$ int]n%ips ( sup]vis$ !rapy4 ,psy*ologi/s w (t5 pr9t _! /ate lic5se numb]s 9 _! telephone directory li/+s4 ,social ,"w ,c\nselors ,social "w c\nselors are li/$ "u ,social ,work]s 9 ! ,yell[ ,pages4 ,usually1 _! li/+s are less specific ?an ^? = psy*iatri/s & psy*ologi/s4 ,mo/ commonly1 y w see li/+s indicat+ lic5s$ ,,mfcc 7m>riage1 family1 #bdg & *ild c\nsel+71 ,,msw 7ma/]'s degree 9 social "w71 ,,lcsw 7lic5s$ cl9ical social work]71 etc4 ,/ate lic5s+ numb]s are (t5 also giv54 ,! ,regi/] ( ,cl9ical ,social ,work]s1 publi%$ by ! ,national ,association ( ,social ,work]s1 li/s memb]s ^: degrees & sup]vis$ tra9+ 7 9 c\nsel+2 x is available 9 _m public libr>ies4 ,specific cr$5tials y may also see 9 directory li/+s include ! foll[+3 ,= !rapi/s ) ,affiliation3 specialties 93 ---------------------------------------- ----------------------------- ,memb]%ip 9 ,am]ican ,psy*oanalysis ,psy*oanalytic ,association 7all memb]s are ,m4,d4s7 ,9 ,canada3 ,memb]%ip 9 ,canadian ,psy*oanalytic ,society ,memb]%ip 9 ,int]national ,psy*oanalytical ,society ,memb]%ip 9 ,national ,psy*ological ,association = ,psy*oanalysis ,tra9+ f ,c5t] = ,/udies ,cli5t-c5t]$ !rapy ( ! ,p]son1 ,la ,jolla1 ,,ca ,tra9+ f ,ge/alt ,!rapy ,ge/alt !rapy ,in/itute ( ,,la 7or ,san ,diego1 ,san ,francisco1 ,new ,york1 ,bo/on1 ,*icago1 ,clevel&1 ,dallas1 ,miami1 ,hawaii1 etc47 ,tra9+ f ,in/itute = ,rational-emotive !rapy ,rational-,emotive ,!rapy 7:i* ma9ta9s a regi/] ( psy*o!rapi/s :o h receiv$ tra9+ 9 ,,ret4 ,address3 #de ,e4 #fe? ,/41 ,new ,york1 ,,ny #ajjba47 ,tra9+ f ! ,in/itute = ,reality !rapy ,reality ,!rapy 79 ,,la1 ) bran*es 9 o!r cities 9 ! ,u4,s47 #bdh ,memb]%ip 9 ,nor? ,am]ican ,adl]ian !rapy ,society ( ,adl]ian ,psy*ology ,memb]%ip 9 ,association = ,behavioral psy*o!rapies ! ,advancem5t ( ,behavior ,!rapy ,memb]%ip 9 ,am]ican ,m>riage & family ,association ( ,m>riage & !rapy ,family ,!rapi/s ,memb]%ip 9 ,bi(e$back ,bi(e$back !rapy ,society ( ,am]ica ,memb]%ip 9 ,am]ican ,hypnosis ,society ( ,cl9ical ,hypnosis ,9 ,canada3 ,memb]%ip 9 ,canadian ,in/itute ( ,hypnotism ,memb]%ip 9 ,am]ican ,treatm5t ( sexual ,association ( ,sex ,educators1 disord]s ,c\nselors1 & ,!rapi/s ,,h>d]-,,to-,,f9d ,,!rapies ,x c be especially difficult or confus+ to locate !rapi/s ) c]ta9 ori5tations1 ei!r because ^! approa*es are less widespread or because y d n "k :i* k9ds ( heal?-c>e pr(essionals make ! greate/ use ( !m4 ,frequ5tly1 an effective way to locate an exi/5tial-humani/ic !rapi/ or logo!rapi/ is ?r\gh religi\s organizations4 ,call to ask = ! names ( m9i/]s1 prie/s1 or rabbis ) tra9+ 9 psy*o!rapy or c\nsel+4 ,^! individuals1 9 turn1 w (t5 be able to put y 9 t\* ) ei!r exi/5tial-humani/ic !rapi/s or logo!rapi/s :o may or may n be affiliat$ ) ! religi\s organization 9 "q4 ,emotional flood+ !rapi/s are usually f\nd among psy*ologi/s1 ^: telephone directory li/+s w normally indicate :e!r !y (f] "o ( ^! !rapies4 ,! same is true = psy*ologi/s ) exp]i5ce 9 direct decision !rapy4 ,bi(e$back !rapi/s c be f\nd 9 private practice2 !y w also be f\nd at pa9 & /ress c5t]s 7:i* are (t5 run by hospitals on an outpati5t basis74 ,^! (f] private or publicly fund$ programs to help p ) *ronic pa9 or #bdi /ress-relat$ difficulties4 ,a numb] ( c\nsel+ ag5cies h begun to include bi(e$back !rapi/s on _! /affs4 ,bi(e$back !rapi/s 9 private practice1 z well z pa9 & /ress c5t]s1 are li/$ 9 telephone directories4 ,try look+ "u ,bi(e$back ,!rapy & ,tra9+ & "u ,psy*ologi/s = ^? :o indicate t !y (f] bi(e$back4 ,relaxation tra9+ 7& sometimes also m$itation7 is frequ5tly (f]$ by bi(e$back !rapi/s 7z well z by _m psy*ologi/s & social work]s74 ,!rapi/s :o use hypnosis are (t5 li/$ "u ,hypnosis 9 telephone directories4 ,y w usually f9d a wide v>iety ( educational backgr\nds repres5t$ among !rapi/s 9 ^! li/+s4 ,"s are 9 private practice2 "s "w = ag5cies4 ,y w probably see an array ( cr$5tials adv]tis$1 p]haps rang+ f !rapi/s )\t degrees1 to ^? ) ,ph4,d4s & ,m4,d4s4 ,"h1 especially1 is an area 9 :i* to ex]cise consum] caution4 ,un=tunately1 hypno!rapy is well populat$ by !rapi/s :o lack pr(essionally recogniz$ cr$5tials4 ,x is wise to rememb] t ,ph4,d4s c be grant$ 9 all sorts ( fields--9 education1 !ology1 libr>ian%ip1 etc4--z well z psy*ology4 ,"s !rapi/s practice ) a ,ph4,d4 aft] _! names1 yet _! ,ph4,d4s may be 9 fields totally unrelat$ to c\nsel+ & psy*o!rapy4 ,ph4,d4s :o are lic5s$ psy*ologi/s & :o are memb]s ( ! ,am]ican ,society ( ,cl9ical ,hypnosis (f] pr(essional cr$ibility z hypno!rapi/s4 ,! c]tification ( !rapi/s tra9$ 9 hypnosis is /ill unsettl$ 9 _m /ates1 :]e anyone c hang out a %+le4 ,s9ce _m lic5s$ psy*ologi/s1 psy*iatri/s1 & "s c]tifi$ social work]s d receive pr(essional tra9+ 9 hypnosis1 ^! are ! pr(essions to :i* x is mo/ reliable to g = hypno!rapy4 ,m$itation te*niques may be le>n$ on y\r own 7see ,*apt] #ae71 or y c seek out comm]cial or religi\s organizations t tea* m$itation4 ,!y are sometimes f\nd 9 ! ,yell[ ,pages "u ,m$itation ,in/ruction4 ,transc5d5tal ,m$itation 7,,tm7 programs h be5 popul> & are widespread4 ,yoga in/ructors 7raja yoga r ?an ha?a yoga7 also tea* m$itation4 ,relatively few psy*ologi/s or social work]s h actually receiv$ tra9+ 9 ! use ( !rapeutic ex]cise1 s9ce ?is area is relatively new & its propon5ts are /ill small 9 #bej numb]4 ,h[ev]1 mo/ psy*ologi/s & _m social work]s are aw>e ( ! ex]cise programs advocat$ by ,ko/rubala & ,glass] 7see ,*apt] #ae7 & c help y plan intellig5tly4 ,,ab\t ,,! ,,co/ ,,( ,,treatm5t ,mo/ heal? insurance plans (f] at lea/ p>tial cov]age = psy*o!rapy & c\nsel+4 ,consult y\r policy to f9d out :at provid]s 7psy*iatri/s1 psy*ologi/s1 or social work]s7 y may g to = cov]$ treatm5t & = h[ long4 7,if y h special conc]ns ab\t confid5tiality 9 connection ) treatm5t "u an insurance plan1 see ,*apt] #ai47 ,z we not$ e>li]1 x is possible to obta9 treatm5t f _m psy*iatri/s1 cl9ical psy*ologi/s1 & social "w c\nselors at r$uc$ co/1 if y h def9ite f9ancial limitations 7see ,*apt] #d74 ,_m cl9ical psy*ologi/s & social work]s indicate 9 _! directory li/+s 9 ! ,yell[ ,pages if fees are set on ! basis ( a slid+ scale-on ! basis1 t is1 ( ability to pay4 ,x is wor? a telephone call to f9d out4 ,_m public & "s private c\nsel+ ag5cies also set fees 9 ?is way4 ,r$uc$ fees f psy*iatri/s are m likely ?r\gh ag5cies t (f] psy*iatric c>e ?an f psy*iatri/s 9 private practice4 ,= public ag5cies1 look 9 ! ,:ite ,pages "u ! "n ( y\r c\nty2 !n look = ! head+ ,m5tal ,heal? ,s]vices or ,c\nty ,m5tal ,heal?1 or ! equival5t4 ,y w frequ5tly f9d "o or m m5tal heal? c5t]s or cl9ics li/$4 ,9 ! ,yell[ ,pages1 look "u ,cl9ics = a li/+ ( private & sometimes also public cl9ics4 ,x is usually cle> f _! descriptions :e!r !y (f] psy*o!rapy or c\nsel+ or only treatm5t = physical illness or injury4 ,aga91 x may be wor?:ile to m5tion t ! co/s ( gr\p !rapy1 :e!r ?r\gh a cl9ical psy*ologi/ or a social "w c\nselor1 may be expect$ to be sub/antially less ?an ! co/s ( individual !rapy4 7,on ! appropriat5ess ( gr\p !rapy1 see ,*apt] #ac47 ,,once ,,y ,,h ,,locat$ ,a ,,!rapi/ ,if y believe y h f\nd a !rapi/ ^: backgr\nd1 fees1 & location meet y\r ne$s1 ,i recomm5d t1 :5 y #bea telephone = an appo9tm5t1 y ask = an initial consultation4 ,?is w make x cle>1 9 ! !rapi/'s m9d & y\r own1 t y\r appo9tm5t is = a trial session4 7,! fee is normally ! same z = a regul> appo9tm5t1 b *eck on ?is47 ,:5 y g to ?is fir/ session1 x is v tempt+ to laun* into :at is tr\bl+ y4 ,if y c hold y\rself back 9 ord] to ask a few prelim9>y que/ions ab\t ! !rapi/'s backgr\nd1 exp]i5ce1 approa*1 & a likely duration ( treatm5t--9 o!r words1 enc\rage ! !rapi/ to talk to y a little bit ab\t himself or h]self--y w get a bett] idea ( ! p]son beh9d ! pr(essional title4 ,?is w help y decide :e!r y want to cont9ue ) future sessions4 ,h[ev]1 x may take sev]al weeks1 or ev5 mon?s1 = y to "k t ! relation%ip w 9 fact b5efit y4 #beb #ah ,,%\ld ,,y ,,be ,,hospitaliz$8 ,!re are two ma9 reasons = psy*iatric hospitalization3 #a4 ,y w\ld be bett] (f away f home4 ,_m ?+s c play a role "h4 ,p]haps !re is too mu* family conflict at home1 too mu* emotional /ra91 = y to improve4 ,or1 y\r family may simply n be calm en\gh to h&le ! crisis4 ,or1 p]haps y h too _m /rong & upsett+ associations at home--e4g41 if y\r sp\se has j di$ or y\r daught] j committ$ suicide at home4 ,or1 y may j h too little privacy at home2 y feel =c$ to ma9ta9 a /iff upp] lip 9 front ( *ildr51 y\r sp\se1 or o!r family memb]s1 b y simply c d ?is no long]4 #b4 ,y\r condition may be too s]i\s to be treat$ appropriately on an outpati5t basis4 ,if y are no long] 9 t\* ) reality1 are unable to communicate coh]5tly1 are halluc9at+ or h delusions1 y _c be reli$ on to take c>e ( y\rself4 ,if y are psy*otic1 y\r behavior may hurt o!rs or y\rself4 ,if y are suff]+ f a major1 incapacitat+ depression1 y may become suicidal4 ,f9ally1 if y are unable to control an addiction to drugs or alcohol1 inpati5t c>e is m likely to be effective4 ,y may1 ( c\rse1 h reasons to resi/ hospitalization4 ,mo/ likely1 y\r resi/ance w be bas$ on fe>--( ! unkn[n1 ( #bec ! lat] /igma ( hav+ be5 hospitaliz$ = a psy*iatric condition1 or ( ! inn] /igma3 t y mu/ h be5 t]ribly ill 7or weak7 to ju/ify hospitalization4 ,fur!rmore1 if y h be5 hospitaliz$ be=e1 y may recall t ! hospital's supportive environm5t enc\rag$ y to feel dep5d5t on x & to resi/ return+ to normal liv+1 & y may fe> fall+ prey to ?is aga94 ,all ( ^! are good reasons to proce$ cauti\sly4 ,only ! fir/ fe> c be reason$ ) 9 an objective way1 by und]/&+ :at psy*iatric hospitalization is really l1 some?+ ?is *apt] w help y to d4 ,c]ta9ly1 ! o!r fe>s also may h "s basis4 ,discrim9ation does /ill exi/ aga9/ =m] psy*iatric hospital pati5ts4 ,!y may f9d x difficult1 = example1 to ent] milit>y s]vice or s]ve 9 an important political capacity4 ,! inn] /igma c be ev5 m damag+1 if y are a highly self-blam+ p]son4 ,if y are go+ to hold hospitalization z yet ano!r black m>k aga9/ y\rself1 !n y may want to avoid hospitalization unless x means y are )hold+ treatm5t f y\rself t really is ess5tial to y\r well-be+4 ,if y h be5 hospitaliz$ be=e = psy*iatric c>e1 ! la/ reason is v likely ! mo/ important "o = y to weigh c>efully4 ,9 ! light ( y\r pa/ dep5d5cy ne$s1 y mu/ decide :e!r ! problems y n[ face are s]i\s en\gh to motivate y to walk into a situation t 9 ! pa/ y f\nd difficult to leave4 ,mo/ hospital admissions = psy*iatric conditions today are volunt>y4 ,usually1 ei!r y\r own judgm5t leads y to accept hospitalization1 or y are p]suad$ by family1 fri5ds1 family doctor1 m9i/]1 or psy*iatri/ t do+ s is 9 y\r own be/ int]e/4 ,involunt>y hospitalization is legally difficult & occurs prim>ily 9 cases 9 :i*1 ov] a p]iod ( "t1 !re is evid5ce t a p]son's behavior is n responsible1 t he _c take c>e ( himself1 or t he may injure himself or o!rs4 ,,:at ,,hospitalization ,,is ,,l ,sev]al k9ds ( hospitalization are available to individuals :o are emotionally tr\bl$3 #bed 99 private or public hospitals 9 :i* !re are special floors or sections = psy*iatric pati5ts 99 hospitals t treat only psy*iatric problems 99 inpati5t programs t specialize 9 /ress managem5t or ! treatm5t ( depression1 alcoholism1 drug abuse1 & o!r problems ,typically1 fifte5 to tw5ty-five pati5ts ( bo? sexes w reside 9 a hospital unit4 ,(t5 a w>d is divid$1 ) m5 liv+ on "o side & wom5 on ! o!r4 ,9 private & _m public hospitals1 private & semiprivate rooms are available1 dep5d+ on y\r ability to pay or y\r insurance cov]age4 ,frequ5tly1 pati5ts dress 9 ev]yday clo!s r ?an 9 hospital g[ns & pajamas4 ,!re is usually a common d9+ area :]e pati5ts c eat at tables seat+ two to f\r p4 ,day rooms are common--l>ge areas ) com=table *airs & c\*es1 a television1 /]eo1 books1 & games4 ,if y 7 admitt$ to a hospital unit specializ+ 9 psy*iatric c>e1 y w\ld probably see a psy*ologi/ or psy*iatri/ two or ?ree times a week 9 individual sessions4 ,x is likely1 s9ce y\r condition 0 s]i\s en\gh to w>rant hospitalization1 t y w receive m$ication dur+ at lea/ "p ( y\r /ay 7see ,*apt] #af74 ,if y are a volunt>y admission1 y w be ask$ to sign cons5t =ms = treatm5t t is recomm5d$ to y4 ,y d h a "r to refuse treatm5t y d n want4 ,a complete physical exam9ation is r\t9ely requir$ to rule out und]ly+ physical disord]s4 ,y may also be ask$ to take "s writt5 psy*ological te/s1 mo/ be+ ( ! multiple-*oice v>iety4 ,gr\p sessions 9 hospitals are common4 ,9 =m+ gr\ps attempts are made to *oose p 9 ways t w be mutually b5eficial4 ,9 "p1 ^! p]iods 9 gr\p help to (fset feel+s ( be+ alone 9 a /range environm5t4 ,activities are plann$ to combat monotony4 ,!y may1 = example1 include arts & crafts1 sports1 danc+1 & day trips to museums or ! movies4 ,/aff memb]s ) :om y w\ld h ! mo/ p]sonal contact are memb]s ( ! psy*iatric nurs+ /aff4 ,(t51 :5 =m] pati5ts are ask$ :o help$ !m :ile 9 ! hospital1 in/ead ( m5tion+ ! !rapi/1 !y "n a #bee memb] ( ! nurs+ /aff4 ,psy*iatric nurses h receiv$ special tra9+ 9 psy*iatry & (t5 are a major s\rce ( human w>m? & c>+4 ,dep5d+ on y\r progress1 y may be enc\rag$ to return home dur+ ! day1 or ov]night1 or = a week5d4 ,z x becomes cle> t y are improv+1 ^! p]iods may be l5g!n$ to see h[ y h&le ! transition f ! hospital1 be=e be+ dis*>g$4 ,al?\gh hospitals expect pati5ts to *oose to rema9 until !y are dis*>g$1 few hospitals actively conf9e volunt>y psy*iatric pati5ts to prev5t !m f leav+ e>ly--& !n g5]ally only 9 cases judg$ to be v s]i\s4 ,! only re/rictions & rules y w\ld likely enc\nt] are ^? ( any hospital3 to respect ! rights ( o!rs1 to be consid]ate1 to refra9 f tak+ drugs unless !y are prescrib$1 to smoke only 9 smok+ areas1 & to ma9ta9 socially acceptable behavior4 ,inpati5t hospital programs specializ+ 9 /ress managem5t1 depression1 eat+ disord]s1 & s on1 are normally int5d$ = "o- to two-week /ays4 ,resid5tial treatm5t c5t]s = problems requir+ long] treatm5t--e4g41 drug & alcohol rehabilitation programs--are less =mal ?an hospitals4 ,(t51 resid5tial treatm5t c5t]s are locat$ 9 ! c\ntry & may consi/ ( a clu/] ( cottage-l build+s4 ,! program is usually "u ! direction ( a psy*iatri/4 ,hospital c>e & resid5tial treatm5t are v exp5sive4 ,mo/ heal? insurance programs cov] mo/ ( ! co/s ( inpati5t psy*iatric hospitalization1 = sev]al weeks or mon?s4 ,public psy*iatric hospitals mu/ be reli$ on by _m p = long] /ays1 unless !y be> ! co/s ( private hospital treatm5t !mselves4 ,physical conditions at /ate psy*iatric hospitals h 9 g5]al improv$ 9 rec5t ye>s b /ill t5d to fall %ort ( private facilities1 = lack ( adequate public fund+4 ,,leav+ ,probably ! mo/ difficult exp]i5ce if y are hospitaliz$ = a psy*iatric condition is leav+1 n ent]+1 ! hospital4 ,!re is frequ5tly a s5se ( relief & com=t t comes once y h made ! decision to ent] a hospital4 ,y h a #bef legitimate reason = leav+ y\r normal responsibilities2 y may feel rescu$ f family or "w situations y c\ld no long] cope )4 ,once y h begun to feel m at home 9 ! hospital sett+1 y beg9 to relax1 to p>ticipate 9 activities ) less re/ra9t or reluctance4 ,!n1 z y improve1 ?anks 9 great "p to ! conc5trat$ att5tion & c>e y are receiv+1 y realize t y mu/ beg9 to ?9k ( re5t]+ life outside4 ,return+ to y\r famili> life c be fright5+4 ,x is usual to wond] :e!r x w1 p]haps aga91 prove to be too mu* ( a /ra94 ,leav+ ! hospital frequ5tly means return+ home or go+ back to "w1 to %\ld] ! same burd5s aga91 try+ to pick up :]e y left (f4 ,hospitalization is (t5 a positive1 reassur+ exp]i5ce4 ,pati5ts become aw>e t o!rs d c>e & t1 if life becomes especially /ressful1 !re are s\rces ( pr(essional help & enc\ragem5t available to fall back on4 ,mo/ hospitals enc\rage =m] pati5ts to ma9ta9 contact ?r\gh foll[-up s]vices ( "s k9d4 ,leav+ ! hospital is made easi] = _m p1 = example1 kn[+ t ! psy*ologi/ or psy*iatri/ is /ill !re & t !y w be se5 on an outpati5t basis4 ,to help =m] hospital pati5ts ease back into m normal lives1 gr\ps t 7 =m$ 9 ! hospital sometimes w also cont9ue to meet on an outpati5t basis = a "t4 ,! decision to be hospitaliz$ is difficult = anyone4 ,hospital c>e may help turn y\r life ar\nd & put y back on y\r feet4 ,or x c1 if y are y\r own wor/ critic1 give y ano!r burd5 to c>ry4 ,x is important to try n to block pot5tially helpful treatm5t ) excessive pride & to try to li/5 to p :o c>e ab\t y4 ,if !y are 9 favor ( ! decision1 _! convictions %\ld be consid]$4 ,if y\r doctor or m9i/] agrees1 ?is adds weight to _! advice4 ,once y h li/5$1 try to make y\r decision y\r own1 n anyone else's4 #beg #ai ,,confid5tiality ,y\r ,privacy ,,! ,,negative ,,label ,,( ,,emotional ,,illness ,society has atta*$ an und5iable /igma to s-call$ emotional or m5tal illness4 ,! public is afraid ( conditions t are n concrete & physical & are less easily und]/ood4 ,emotional or m5tal difficulties seem m hidd5 & my/]i\s4 ,! body is tangible1 & we feel we h m control ov] x4 ,sett+ a brok5 leg1 hav+ y\r app5dix remov$1 ev5 op5-he>t surg]y--!y are n difficult = ! public to grasp4 ,h[ev]1 depression1 anxiety1 intol]ance to /ress1 disori5tation1 unsettl+ fe>s1 unusual behavior--^! are mu* less readily und]/ood by nonspeciali/s4 ,!re is a t5d5cy = _m p to judge r h>%ly :at !y d n compreh5d4 ,:5 _m individuals :o are ignorant ( psy*ology he> ( someone 9 emotional di/ress1 ! incl9ation is (t5 to condemn4 ,condemnation is frequ5tly an expression ( fe>--fe> ( :at is n und]/ood4 ,dur+ ! la/ two to ?ree decades1 society has gradually become m psy*ologically aw>e & m intellig5t ab\t nonphysical problems4 ,& yet1 ! /igma ( emotional or m5tal illness has /ill n be5 eras$4 ,x w take "t4 #beh ,z a result1 _m p :o are 9 s]i\s emotional di/ress hesitate to g to a !rapi/4 ,!y are afraid ( ! negative label t o!rs may apply to !m1 if in=mation ab\t !m ev] got out4 ,sometimes ?is is a ju/ifiable worry4 ,"s employ]s are bigot$ & may discrim9ate aga9/ employees ) kn[n emotional problems 7ev5 ?\gh ?is is blatantly illegal74 ,& "s families1 9 :i* !re is little psy*ological und]/&+ & mu* fe>1 may )draw f a family memb] :o lets x be kn[n t he or %e is 9 emotional di/ress4 ,on ! o!r h&1 mo/ p l to feel t !y h a c]ta9 degree ( compassion & op5ness--ev5 ^? :o are judgm5tal6 ,if y are will+ to face ignorant attitudes head-on1 unfl9*+ly 7& ?is c take a great deal ( c\rage71 y w frequ5tly ga9 ! respect ( o!rs ?r\gh y\r hone/y4 ,!y w p]ceive y\r unwill+ness to judge y\rself negatively & may ev5 come to admire ! /r5g? & det]m9ation y h to improve y\r life4 ,if y are 9 emotional di/ress1 y may h to face a dilemma3 :e!r x is prud5t to try to conceal y\r difficulties f p because y believe t "s ( !m may judge y h>%ly & critically if !y f9d out y are 9 !rapy1 or :e!r x is likely t !y w\ld und]/&1 & p]haps ev5 sympa?ize1 if y 7 able to be op5 & _h ! c\rage & self-confid5ce to help educate o!rs on a psy*ological level4 ,un=tunately1 p 9 real emotional di/ress don't h ! en]gy1 ! c\rage1 or ! self-confid5ce to fight social battles6 ,x !re=e usually seems to be a great deal easi] to try to keep y\r own affairs private4 ,b ?is is n always simple to d4 ,,! ,,confid5tiality ,,( ,,psy*o!rapy ,confid5tiality z x relates to c\nsel+ & psy*o!rapy is n a /raight=w>d ?+2 mu* t has to d ) confid5tiality is /ill an unsettl$ & /ill debat$ issue4 ,9 reality1 !re are z yet few laws t fully & g5u9ely protect p]sonal privacy4 ,!re are two c5tral que/ions relat+ to confid5tiality t ,i want to raise "h4 ,! fir/ is a "q only y c answ]4 ,i w try to discuss "s ( ! answ]s to ! second4 #bei ,,h[ ,,important ,,is ,,confid5tiality ,,to ,,y8 ,only y c answ] ?is4 ,x may be reassur+ to "k t1 usually1 ! safegu>ds obs]v$ by !rapi/s are suffici5t to protect ! p]sonal affairs ( cli5ts4 ,& x is unusual = any real or la/+ h>m come to a cli5t if in=mation ab\t him or h] is releas$4 ,_m individuals1 :5 !y are trapp$ 9 a prison ( self-conc]n & self-involvem5t1 are prone to exagg]ate or magnify ! ultimate significance ( be+ discov]$ 9 !rapy1 believ+ t a release ( in=mation ab\t !m w be pot5tially explosive & damag+4 ,individuals :o are emotionally v upset are incl9$ to focus on ?reat5+ aspects ( !rapy4 ,we h already look$ at "s ( ! ways t a height5$ s5sitivity to ma9ta9 secrecy ab\t y\r problems c lead to self-imprisonm5t1 to blocks t /& 9 ! way ( positive *ange 7see ,*apt] #a74 ,mo/ ( ! in=mation y may want kept secret may n really be z damag+ z y fir/ 7 incl9$ to ?9k4 ,mu* dep5ds on h[ y respond to in=mation t might be releas$ ab\t y4 ,let's look at an example4 ,a little m ?an a ye> ago1 ,george ,malcolm became s]i\sly depress$4 ,he 0 =c$ to resign f 8 job1 & !n he receiv$ disability income = t5 mon?s4 ,dur+ ?is "t he ent]$ !rapy4 ,8 exp]i5ce help$ him to und]/& a numb] ( important ?+s ab\t himself t he _h ignor$ 9 ! pa/4 ,he discov]$ t he _h felt v unsatisfi$ 9 8 previ\s job2 he _h buri$ 8 fru/rations & _h suppress$ ! ang] he felt at be+ trapp$ 9 a situation he dislik$4 ,x 0 a situation he felt he _h no control ov] because ( 8 conc]n = 8 & 8 family's f9ancial security4 ,he 0 also worri$ ab\t 8 "m1 :o w\ld probably h to be admitt$ to a nurs+ home 9 ! ne> future4 ,h] situation 0 an add$ reason = ,george's f9ancial worry4 ,he also came to realize t 8 m>riage 0 suff]+ because ( 8 insi/5ce t 8 wife n "w4 ,%e1 on ! o!r h&1 felt ov]controll$ by h] husb&3 %e felt t he /ood 9 ! way ( h] p]sonal gr[?4 ,z a result ( 8 increas$ aw>5ess1 ,george came to see t los+ 8 =m] job 0 really a bless+ 9 disguise4 ,8 m>riage began to improve :5 ,george's depression = ! #bfj fir/ "t put him 9 a dep5d5t position2 he ne$$ 8 wife's emotional support1 & %e1 9 turn1 began to see him z a p]son1 ) weaknesses ( 8 own1 & n z %e _h idealiz$ him4 ,george's depression all[$ him to und]/& & appreciate 8 wife's previ\sly fru/rat$ s5se ( initiative4 ,he n[ enc\rag$ h] to d :at %e _h long want$ to d1 to develop a c>e]4 ,because ,george receiv$ disability dur+ 8 depression1 8 insurance company _h in=mation ab\t him on file4 ,:5 ,george 0 int]view$ = a new job a ye> aft] he became depress$1 he 0 ask$ at ! int]view if he _h be5 ill dur+ ! prec$+ ye>1 :5 he _h n work$4 ,george decid$ to be tru?ful & said t he _h become depress$ & t z a result ( ! exp]i5ce _h le>n$ mu* ab\t himself4 ,9 p>ticul>1 he _h le>n$ :at k9d ( "w really int]e/$ him & gave him a s5se ( satisfaction4 ,al?\gh x _h be5 a difficult p]iod1 ,george said t he felt he _h ga9$ a great deal f ! exp]i5ce4 ,george's prospective employ] 0 impress$ by ,george's hone/y & evid5t s9c]ity4 ,george got ! job--9 l>ge "p because ( ! attitude he took t[>d 8 depression4 ,,:at ,,laws ,,protect ,,confid5tiality8 ,to :at ext5t is y\r privacy protect$8 ,:at situations legally ju/ify y\r !rapi/ to release in=mation ab\t y8#a #a ,s9ce ! fir/ edition ( ?is book1 ! ,heal? ,insurance ,portability & ,acc\ntability ,act 7,,hipaa7 0 pass$ 9 #aiif1 br++ ) x a mass ( complexities relat+ to pati5t privacy4 ,!re rema9 _m /ill unsettl$ legal que/ions & issues relat+ to ! s-call$ ,privacy ,rule1 :i* !re is n space "h to discuss4 ,if y wi% to "k m ab\t ! legal /atus & int]pretation ( pati5t privacy1 see ,wikip$ia's article ab\t ,,hipaa at3 http3_/_/en4wikip$ia4org_/wiki_/,,hipaa4 ,^! que/ions d n always h cle>-cut answ]s4 ,!re may or may n be special laws 9 y\r /ate to protect ! confid5tiality ( psy*o!rapy4 ,! legal /atus ( !rapy is /ill ambigu\s 9 _m /ates4 ,ev5 9 ^? :]e laws h be5 pass$1 legal protection is sometimes n reliable unless y\r !rapi/ is will+ to face a jail s5t5ce if ne$ be to ma9ta9 ! confid5ce y h entru/$ 9 him4 ,if y feel a situation is likely to arise t w\ld put legal pressure on y\r !rapi/ to release in=mation ab\t y 7= example1 9 a *ild-cu/ody he>+71 y %\ld ask y\r !rapi/ :at 8 or h] commitm5ts to confid5tiality are4 ,leaks ,m frequ5tly1 confid5tiality is brok5 due to in=mality #bfa r ?an due to an int5tional release ( in=mation4 ,= example1 if y are ref]r$ to ano!r !rapi/ or to a physician1 ! *ances are t in=mation ab\t y w be %>$ by y\r orig9al !rapi/ ) ! new !rapi/ or doctor4 ,y c ask y\r !rapi/ n to release in=mation 9 ?is way1 b if y d1 ! c>e y receive z a result ( ! ref]ral _c b5efit f y\r fir/ !rapi/'s und]/&+ ( y4 ,on ! o!r h&1 if y d p]mit y\r file to be %>$ ) a new !rapi/ or doctor1 y w probably n "k 9 advance "k :at 8 or h] own policies ab\t confid5tiality are4 ,!re is a second way t in=mation ab\t y may be releas$4 ,(t51 !rapi/s discuss in=mation ab\t _! cli5ts ) colleagues 9 an ef=t to provide bett] help = !m4 ,x is (t5 to y\r def9ite advantage to h o!r !rapi/s %>e _! assessm5ts & ideas ) y\r !rapi/4 ,b if y ask y\r !rapi/ to refra9 f discuss+ y\r case ) pr(essional colleagues1 he or %e w v likely agree to coop]ate ) y4 ,if y believe y h special reasons to be conc]n$ ab\t protect+ ! confid5tiality ( y\r relation%ip ) y\r !rapi/1 x w help him or h] to "k ?is1 & x may be possible to reque/ t special precautions be tak5 to protect y\r file f access by o!rs4 ,accid5tal or inadv]t5t breaks ( confid5tiality sometimes c also occur4 ,= example1 bill+s may be mail$ to y\r address & !n be op5$ by a sp\se1 *ild1 or p>5t :om y may n h want$ told t y 7 9 !rapy4 ,"h is ano!r example3 ,if y ent] gr\p !rapy1 o!r memb]s ( ! gr\p are n pr(essionally b\nd by rules gov]n+ confid5tiality4 ,because !y are n c\nsel+ #bfb pr(essionals !mselves1 !y w be less att5tive to matt]s involv+ confid5tiality--al?\gh mo/ gr\p !rapi/s try1 :5 a gr\p is fir/ =m$1 to get gr\p memb]s to agree n to disclose privileg$ in=mation outside ( sessions4 ,exceptions ,beyond ! k9ds ( possible breaks ( confid5tiality t are due to inatt5tion1 in=mality1 & access ( in=mation ab\t y by o!rs1 !re are a numb] ( legal exceptions to confid5tiality4 ,exam9ation by c\rt ord] is "o4 ,if a judge ord]s y to be exam9$ by a psy*iatri/ or psy*ologi/1 8 f9d+s w be transmitt$ to ! c\rt & s be made public4 ,if a cli5t reveals 8 or h] int5tion & decision to commit a crime1 a !rapi/ is legally requir$ to report ?is to au?orities4 ,if a pati5t plans to commit homicide1 !rapi/s are requir$ by law to take :atev] action is necess>y to prev5t ! murd]4 ,9 ,cali=nia1 9 addition to w>n+ ! police ( ! homicidal int5tions ( a cli5t1 !rapi/s mu/ also take /eps to w>n ! int5d$ victim1 if ?is is possible4 ,if a pati5t is s]i\sly suicidal--t is1 has decid$ on a means to commit suicide1 has decid$ :5 to d ?is1 & _c be p]suad$ to hold (f :ile 9 !rapy--! !rapi/ is legally b\nd to take :atev] action may be necess>y to prev5t ! pati5t's suicide1 includ+ ! disclosure ( p]t95t in=mation to public (ficials4 ,simil>ly1 9 cases ( *ild abuse or neglect1 ! law requires t a cli5t's confid5tial relation%ip ) 8 or h] !rapi/ be set to "o side 9 ord] to provide adequate protection & c>e = ! *ild4 ,,?reats ,,to ,,privacy ,,f ,,heal? ,,insurance ,,companies ,!re is ano!r way t privacy c be invad$1 & = _m p x is little kn[n & m significant ?an ! breaks ( confid5tiality we h already discuss$4 ,x comes ab\t z a result ( rec5tly =m$ data banks t are ma9ta9$ & cont9u\sly updat$ by insurance companies4 ,in=mation ab\t insurance claims & paym5ts n only are kept on file by individual insurance companies1 b a numb] ( national data banks h be5 e/abli%$ to provide insurance #bfc companies ) in=mation ab\t ! heal? hi/ories ( individuals4 ,= example1 if y file a heal? insurance application or a claim = b5efits ) _m insurance companies1 !y (t5 w run a *eck on y\r heal? hi/ory ?r\gh a national comput]iz$ cle>+h\se t ma9ta9s insurance in=mation4 ,?is in=mation includes data ab\t previ\s insurance claims y may h made4 ,insurance companies believe t !y h a "r to data ( ?is k9d1 s9ce ! in=mation protects !m f hav+ to pay = heal? c>e co/s t come ab\t due to preexi/+ conditions1 :i* _m insurance policies limit or exclude4 ,too1 if y h suff]$ f poor heal? 9 ! pa/1 & 7 cov]$ by insurance1 !re are probably data ab\t y\r heal? hi/ory on file 9 su* a national comput]iz$ cle>+h\se2 by access+ in=mation ab\t y1 an insurance company is able to =m a judgm5t z to :e!r y are an excessive risk4 ,l any in=mation ab\t y t has be5 compil$ & is furni%$ )\t y\r cons5t1 ^! data ab\t y\r heal? hi/ory--ma9ta9$ by ag5cies t s]vice insurance companies--are subject to possible abuse4 ,in=mation on file c & is us$ to protect ! int]e/s ( subscrib+ insurance companies2 y\r own int]e/s may n be s]v$ 9 ! process4 ,n only might y be d5i$ future insurance b5efits1 b ! in=mation ma9ta9$ ab\t y is subject to :atev] use ! insurance cle>+h\se believes is appropriate4 ,z yet1 laws to secure a true measure ( p]sonal privacy h n be5 pass$4 ,?is has be5 "o ( ! goals ( organizations l ! ,am]ican ,civil ,lib]ties ,union4 ,!re is a second insurance-relat$ issue t has to d ) confid5tiality4 ,if y h gr\p heal? insurance ?r\gh y\r employ]1 x w be necess>y = y\r !rapi/ to complete reports ab\t y 9 ord] = y to receive b5efits "u y\r insurance plan4 7,i am assum+ "h t y\r insurance (f]s cov]age = c\nsel+1 psy*o!rapy1 or psy*iatry47 ,! reports fil$ by y\r !rapi/ ) ! gr\p heal? insurance company are sometimes fil$ ?r\gh y\r employ]1 & sometimes employ]s require _! gr\p heal? companies to provide !m ) in=mation ab\t heal? c>e suppli$ to _! employees4 ,9 ei!r way1 ! fact t y are 9 !rapy & ! g5]al reasons = y\r ne$ = !rapy may come to ! att5tion ( y\r employ]4 #bfd ,if y\r employ] is a l>ge company or organization1 su* in=mation w probably be fil$ 9 y\r employ]'s bus9ess or insurance (fice & laid to re/2 x w probably n come to ! att5tion ( individuals y actually deal ) 9 y\r "w4 ,b x may4 ,9 a small] company1 !re is a great] risk4 ,if y are really conc]n$ ab\t ?is possibility1 ask y\r insurance (fic] h[ heal? claims are h&l$ & :e!r heal? in=mation is reque/$ by y\r employ] f ! insurance company4 ,if y are !n /ill conc]n$ & feel t y ne$ to avoid pot5tial complications at "w1 y may pref] to see a !rapi/ on y\r own & refra9 f us+ y\r employ]'s insurance cov]age4 ,if y see a !rapi/ 9 private practice1 y\r decision to pay y\r own bill may be exp5sive = y4 ,if f9ances are a problem1 be> 9 m9d t y c frequ5tly locate compet5t help ?r\gh c\nty1 /ate1 or private c\nsel+ ag5cies4 ,if y g to an ag5cy1 rememb] t y w almo/ c]ta9ly be ask$ :e!r y h insurance cov]age4 ,if y admit t y d1 y w h defeat$ y\r purpose 9 go+ to an ag5cy on y\r own to protect y\r privacy4 ,x is1 aft] all1 y\r "r to obta9 treatm5t t y elect to pay =4 ,,magnify+ ,,y\r ,,ne$ ,,= ,,secrecy ,aft] review+ ^! ways 9 :i* confid5tiality may be brok5--by accid5t or sometimes excessive in=mality1 by legal requirem5ts1 or by :at to _m ( u con/itutes an invasion ( p]sonal privacy by insurance companies--y may wond] to :at ext5t in=mation t y disclose 9 !rapy really is protect$4 ,9 fact1 v seldom are ! details ( !rapy divulg$ to o!rs )\t a cli5t's advance cons5t4 ,mo/ ( u d n ne$ to be worri$ by legal exceptions to confid5tiality3 mo/ ( u are n actually homicidal 7?\gh we may feel v angry at times672 mo/ ( u are n det]m9$ to take our lives 7?\gh we may at times feel v di%e>t5$72 mo/ ( u are n conc]n$ t a c\rt w ord] u to be exam9$ by a psy*iatri/4 ,i h tri$ to give a reali/ic picture ( confid5tiality 9 !rapy4 ,! fact t y receive m5tal heal? c\nsel+ or !rapy may inadv]t5tly be disclos$ by su* ?+s z a bill+ t goes a/ray or #bfe by a fell[ gr\p memb]'s incl9ation to talk too mu* outside ( ! gr\p4 ,if y decide to make use ( insurance cov]age1 !re are possible consequ5ces y ought to be aw>e (4 ,i h tri$ to und]l9e ! fact t mo/ p :o ent] !rapy bl[ out ( proportion ! real significance ( ^! possible1 b comp>atively infrequ5t1 leaks4 ,k>l ,a4 ,m5n+]1 a r5[n$ & orig9al contributor to psy*iatry1 quotes "o ( 8 pati5ts :o %>$ h] intellig5t reflections ) him3 ,:5 ,i look back ^u ! _m mon?s ,i pond]$ z to h[ ,i might get "h )\t anyone kn[+1 & ! devi\s r\tes ,i consid]$ & actually took to accompli% ?is1 only to realize t "s ( ! symptoms f :i* ,i suff] are respectable en\gh to be ackn[l$g$ any:]e & valid en\gh to expla9 my com+ "h1 x all seems s utt]ly ridicul\s4 ,i look$ furtively out ( ! corn] ( my eye at ! p ,i met "h1 expect+ !m to betray _! %ame or _! que]ness1 only to discov] t ,i (t5 c\ld n di/+ui% ! pati5ts f ! physicians1 or f o!r visitors4 ,i suppose x is su* a commonplace exp]i5ce to y t y _c realize h[ />tl+ t is to a naive layman1 l myself1 ev5 "o :o ?9ks he has read a little & laid aside "s ( ! prov9cialism & prejudice :i* to "s ext5t bl9d u all4 ,i see h[ !re is some?+ emotional 9 x2 if ! pati5t feels only depress$ or guilty or confus$1 !n "o looks ^u 8 consult+ ! psy*iatri/ z a disgraceful rec\rse2 b if "s ( ! symptoms take =m 9 "o ( ! bodily organs1 all ! %ame vani%es4 ,!re is no s5se to x1 b t's h[ x is4 ,i h writt5 a doz5 lett]s to tell p :]e ,i am1 ! v p f :om 9 ! pa/ six mon?s ,i h tri$ to conceal my ne$ ( ?is4#b #b ,k>l ,a4 ,m5n+]1 ,man ,aga9/ ,himself 7,new ,york3 ,h>c\rt1 ,brace & ,company1 #aich71 pp4 #dee-def4 ,,don',t ,,let ,,exagg]at$ ,,worries ,,hold ,,y ,,back ,:5 y /op = a mom5t to consid] h[ widespread p]sonal problems are--#bj p]c5t ( ,am]icans h s]i\s emotional difficulties--isn't !re some?+ silly1 ridicul\s1 &1 frequ5tly1 self-defeat+ 9 be+ ov]ly conc]n$ ab\t #bff keep+ o!rs f kn[+ t1 = a "t1 y 7 depress$1 anxi\s1 unsatisfi$1 & fru/rat$ to ! po9t t y decid$ to d some?+ ab\t ^! unhappy feel+s8 ,to be sure1 discretion is sometimes prud5t4 ,an employ]1 y\r family1 or "s ( y\r fri5ds may be s prov9cial or bigot$ z to ?9k t c\nsel+ is close to a misdemeanor4 ,ignorant or un9=m$ p d t5d to judge ha/ily & to condemn4 ,b (t51 if y d h ! endurance1 _m ( !m are also will+ to *ange _! m9ds :5 !y h ! opportunity to und]/& a little bit ab\t :at !y fe>4 ,y _c live = ! approval ( o!rs4 ,if y believe !rapy may help y improve y\r life1 don't all[ y\rself to be held back by exagg]at$ worries4 ,x usually is possible to keep confid5tial ! fact t y h ent]$ !rapy :5 !re are especially compell+ reasons to ex]cise =esight & caution4 ,expla9 y\r conc]ns to y\r !rapi/2 he or %e c !n make e ef=t to help y4 #bfg #bj ,,does ,,!rapy ,,"w8 ,:e!r or n !rapy works is a "q t has h\nd$ psy*o!rapi/s = m ?an ?irty ye>s1 :5 evaluative /udies began to ca/ d\bts on its effectiv5ess4 ,s9ce !n1 sev]al hundr$ /udies ( ! effectiv5ess ( psy*o!rapy h be5 made4 ,"s ( !m appe> to %[ t psy*o!rapy is highly successful1 & _m h po9t$ to evid5ce t psy*o!rapy is no m effective ?an no treatm5t at all4 ,! ambiguity ab\t ?is issue has be5 v tr\blesome to !rapi/s & t5ds n to be op5ly discuss$ ) cli5ts1 = obvi\s reasons4 ,:y reports ab\t psy*o!rapy's effectiv5ess h be5 s contradictory & ambigu\s has nev] be5 made cle>4 ,b und]/&+ ! reasons beh9d ^! oppos+ claims w give u a basis = optimism4 ,,claims ,,aga9/ ,,! ,,effectiv5ess ,,( ,,psy*o!rapy ,if p :o are emotionally tr\bl$ get well ?r\gh psy*o!rapy 9 ab\t ! same l5g? ( "t z ^? :o are n giv5 any treatm5t at all1 we w\ld be incl9$ to say t #bfh psy*o!rapy didn't help4 ,sev]al /udies h %[n t ! majority ( p ) neurotic disord]s improve spontane\sly1 on ! av]age1 9 "o to two ye>s4#a ,:5 p ) simil> problems are treat$ ) psy*o!rapy1 ! outcome is virtually ! same3 ! spontane\s remission rate = all practical purposes is ! same z ! rate ( success due to !rapy4 ,psy*o!rapy doesn't seem to make a diff]5ce4 ,we'll call ?is ! spontane\s remission criticism & w come back to x 9 a mom5t4 #a ,s4 ,ra*man1 ,! ,effects ( ,psy*o!rapy 7,new ,york3 ,p]gamon ,press1 #aiga7 p4 #ah4 ,mo/ /udies ( ! effectiv5ess ( psy*o!rapy make use ( placebo treatm5ts3 a gr\p ( emotionally tr\bl$ individuals is treat$ ) "o ( ! major approa*es to psy*o!rapy by well-tra9$ !rapi/s1 & ano!r gr\p ( simil>ly tr\bl$ p is treat$ by untra9$ !rapi/s :o (f] _! cli5ts a !rapy t is simply made up b is c>efully pres5t$ s z to be believable4 ,&1 aga91 x turns out t cli5ts treat$ ) ! legitimate !rapy improve1 b n significantly m ?an ^? 9 ! placebo gr\p4 ,we'll call ?is ! placebo criticism & w come back to x1 too1 9 a mom5t4 ,a few /udies h %[n t psy*o!rapy c actually be injuri\s to cli5ts4 ,a disord] br\ght ab\t by m$ical treatm5t is call$ an iatrog5ic di/urbance4 ,iatrog5esis is ! ,greek ^w = br\ght ab\t by doctors4 ,if ! iatrog5esis criticism is valid1 !n !rapy may be n only ineffective b sometimes actually h>mful4#b #b ,see1 = example1 ,?omas ,j4 ,n>di1 ,psy*o!rapy3 ,cui ,bono81 9 ,jusuf ,h>iman1 ed41 ,does ,psy*o!rapy ,really ,help ,p8 7,spr+field1 ,,il3 ,*>les ,c4 ,?omas1 #aihd71 pp4 #aed-afd4 ,toge!r1 ^! ?ree criticisms h made !rapi/s feel v def5sive--& rightly s4 ,if fictiti\s treatm5t by a mock !rapi/ works z well z treatm5t provid$ by a man or woman :o has tra9$ long & h>d = a ,ph4,d4 or ,m4,d41 w\ldn't y feel ill at ease--p]haps v mu* ill at ease6--*>g+ y\r cli5ts #ge to #ajj an h\r = y\r "t = a s]vice t is no bett] ?an none at all & may ev5 cause y\r cli5ts to get worse8 ,^! are n trump$-up *>ges aga9/ psy*o!rapy t we c af=d to ignore4 ,!rapi/s don't l to confront !m4 ,"h are "s ( ! results ( rese>* /udies3 #bfi 444 ,as comp>$ ) spontane\s remission1 !re is no good evid5ce to sugge/ t psy*o!rapy & psy*oanalysis h effects t are 9 any way sup]ior4#c #c ,hans ,j4 ,eys5ck1 ,! ,battle ov] ,!rapeutic ,effectiv5ess1 9 ,j4 ,h>iman1 ed41 ,does ,psy*o!rapy ,really ,help ,p81 p4 #ei4 444 ,mo/ ( ! v]bal psy*o!rapies h an effect size t is only m>g9ally great] ?an ! effect size = 444 a placebo treatm5t4#d #d ,edw>d ,erw91 ,is ,psy*o!rapy ,m ,effective ,?an a ,placebo81 9 ,does ,psy*o!rapy ,really ,help ,p81 p4 #ci4 ,mo/ writ]s 444 agree t ! !rapeutic claims made = psy*o!rapy range f ! abysmally l[ to ! a/oni%+ly high &1 fur!rmore1 !y w\ld t5d to agree t on ! av]age psy*o!rapy appe>s to produce approximately ! same am\nt ( improvem5t z c be obs]v$ 9 pati5ts :o h n receiv$ ?is type ( treatm5t4#e #e ,ra*man1 ,! ,effects ( ,psy*o!rapy1 p4 #hd4 444 ,us+ placebo treatm5t z a prop] control 7:i* x und\bt$ly is71 we f9d t ! alleg$ effectiv5ess ( psy*odynamic !rapy i4e41 psy*oanalysis vani%es almo/ completely4#f #f ,eys5ck1 ,! ,battle ov] ,!rapeutic ,effectiv5ess1 p4 #ef4 ,!re is /ill no acceptable evid5ce to support ! view t psy*oanalytic treatm5t is effective4#g #g ,ra*man1 ,! ,effects ( ,psy*o!rapy1 p4 #fc4 444 ,t"h is no relation%ip betwe5 duration ( !rapy & effectiv5ess ( !rapy4#h #h ,eys5ck1 ,! ,battle ov] ,!rapeutic ,effectiv5ess1 p4 #eg4 ,psy*o!rapy ( any k9d applies te*niques t are bas$ on c]ta9 !ories1 & ^! !ories dem& n only t !re %\ld be correlation betwe5 success & l5g? ( treatm5t1 b also t ! tra9+ & exp]i5ce ( ! !rapi/ %\ld be extremely important4 ,to f9d t nei!r ( ^! coroll>ies is 9 fact borne out mu/ be an absolute dea? bl[ to any claims to h demon/rat$ ! effectiv5ess ( psy*o!rapy4#i #i ,ibid4 ,! pessimism produc$ by ^! conclusions 0 summ$ up by ,hans ,j4 ,eys5ck1 pr(essor at ! ,in/itute ( ,psy*iatry 9 ,london3 #bgj ,i h always felt t x is completely une?ical to subject neurotic pati5ts to a treatm5t ! efficacy ( :i* has n be5 prov51 & inde$1 ! efficacy ( :i* is v mu* 9 d\bt--s mu* s t !re is no good evid5ce = x1 9 spite ( hundr$s ( /udies devot$ to ! "q4 ,pati5ts are ask$ to sp5d money & "t !y c ill af=d1 & subject !mselves to a gruell+ exp]i5ce1 to no good purpose at all2 ?is surely _c be "r4 ,at lea/ !re %\ld be a /atutory w>n+ to ! effect t ! treatm5t !y are propos+ to ent] has nev] be5 %[n to be effective1 is v l5g?y & co/ly1 & may inde$ d h>m to ! pati5t4#aj #aj ,eys5ck1 ,! ,battle ov] ,!rapeutic ,effectiv5ess1 9 ,does ,psy*o!rapy ,really ,help ,p81 p4 #ei4 ,,:y ,,pessimism ,,is ,,unf\nd$ ,i hold all contempor>y psy*iatric approa*es--all m5tal-heal? me?ods--z basically flaw$ because !y all se>* = solutions along m$ical-te*nical l9es4 ,b solutions = :at8 ,= life6 ,b life is n a problem to be solv$4 ,life is some?+ to be liv$1 z intellig5tly1 z compet5tly1 z well z we c1 day 9 & day out4 ,life is some?+ we mu/ endure4 ,!re is no solution = x4#aa #aa ,?omas ,szasz1 int]view$ 9 ,jona?an ,mill]1 ,/ates ( ,m9d 7,new ,york3 ,pan!on ,books1 #aihc71 p4 #bij4 ,we mu/ grab ! bull by ! horns4 ,?\s&s ^u ?\s&s ( p cont9ue to ent] psy*o!rapy4 ,h[ long w\ld any s]vice la/ if x fail$ to s]ve ! ne$s ( its m>ket8 ,x is tempt+ to suppose t some?+ con/ructive1 at lea/ sometimes1 happ5s z a result ( psy*o!rapy to ju/ify ! "t1 exp5se1 & fai? ( cli5ts4 ,or is _! fai? really misplac$8 ,"o ( ! mo/ outspok5 critics ( psy*o!rapy is psy*iatri/ ,?omas ,szasz4 ,8 views are an unlikely s\rce = a def5se ( psy*o!rapy1 b its def5se1 oddly en\gh1 c be f\nd !re4 ,szasz argues t psy*ology has be5 influ5c$ by ! disease model t dom9ates m$ic9e4 ,m$ic9e bases its conception ( treatm5t on ! fact t !re are diseases 7or #bga injuries7 t c be help$ by means ( drugs or surg]y4 ,illnesses & injuries are treatable conditions4 ,treatm5t is appli$ f outside by ! physician1 & ! condition1 :5 ! treatm5t is effective1 improves4 ,b psy*iatry goes a /ep too f> :5 x claims t p :o become emotionally helpless1 hopeless1 lonely1 or agitat$ are actually sick4 ,szasz claims t !y are n sick2 !y are helpless1 hopeless1 lonely1 or agitat$4 ,^! are n illnesses b1 r1 "s ( ! tragic conditions ( life4 ,!y are problems ( liv+4 ,= ,szasz--& = !rapi/s l ,viktor ,frankl & ,alfr$ ,adl]--psy*ological problems resemble moral problems mu* m ?an !y d physical diseases4 ,!y involve disc\ragem5t1 loss ( morale1 loss ( moral c\rage4 ,!y are /ates ( demoralization4 ,n[1 demoralization is n a treatable condition--n1 c]ta9ly1 9 ! m$ical s5se4 ,y _c apply treatm5t f )\t & expect t ! pati5t w get bett]4 ,! situation is mu* m complex ?an ?is4 ,! pati5t--let's %ift at ?is po9t to call+ him or h] ! cli5t--is mu* m actively involv$ 9 ! process ( psy*o!rapy ?an is a pati5t 9 m$ic9e4 ,a woman :o contracts pneumonia c be cur$ ) antibiotics :ile %e lies 9 b$ wat*+ television or sleep+4 ,b an emotionally tr\bl$ woman--:o has _h a succession ( unhappy m>riages1 :o has lo/ job aft] job1 ^: p]sonality is (f5sive to o!rs1 :o has a l[ s5se ( self-wor?1 & :o has lo/ a s5se ( mean+ & direction 9 life--_c be cur$ :ile %e lies 9 b$ & is treat$ ) appropriate m$ication4 ,effective treatm5t j isn't possible2 too mu* is up to ! cli5t h]self4 ,basically1 ?is is :y /udies ( ! effectiv5ess ( psy*o!rapy h g5]ally l$ to disc\rag+ results4 ,mo/ psy*ological conditions 7!re are exceptions1 z we w see7 are n1 at lea/ at pres5t1 treatable 9 ! m$ical s5se4 ,to combat !m requires ( ! cli5t a great deal ( 8 or h] own ef=t & ev5 ex]tion4 ,!y require self-discipl9e1 moral c\rage1 fai? 9 oneself--all ! ?+s emotional di/ress t5ds to und]m9e4 ,no approa* to psy*o!rapy c itself be m$ically effective 9 treat+ conditions l ^!4 ,someh[1 ! cli5t mu/ rea* a po9t :]e he c lift himself by ! boot/raps4 ,he c be enc\rag$ by ! !rapi/1 he c be reason$ )1 he c be #bgb manipulat$ 9 /rategic !rapeutic ways1 ! !rapi/ c exhort him to be rational1 b ! focus always comes back to ! cli5t4 ,is he or %e motivat$ to le>n h[ to *ange8 ,is he or %e an effective le>n]--t is1 a good /ud5t8 ,! hundr$s ( attempts to evaluate ! effectiv5ess ( approa*es to psy*o!rapy h1 incr$ibly1 left out ?is ess5tial ref]5ce to ! cli5ts !mselves3 ,:at k9d ( p are !y8 ,:at enc\rages !m8 ,:at c act z a s\rce = _! motivation1 = ! /r5g? !y h lo/8 ,ironically1 ! answ] to ^! que/ions also lies unwitt+ly 9 ! h&s ( psy*o!rapy's h>%e/ critics4 ,! wor/ bl[ to fall on ! %\ld]s ( psy*o!rapi/s 0 dealt by placebo /udies4 ,exp]im5ts 7 design$ t w\ld conv9ce a gr\p ( emotionally tr\bl$ cli5ts t tak+ a p9k pill 79 reality1 a sug>-fill$ placebo7 w\ld r$uce _! symptoms4 ,9 fact1 _! symptoms 71 9 g5]al1 r$uc$1 & (t5 by z mu* z treatm5t 9 =mal psy*o!rapy4 ,?is fact has be5 int]pret$ by mo/ !rapi/s to mean t psy*o!rapy mu/ !re=e h be5 ineffective4 ,if a p9k & useless pill c\ld equal ! effects ( !rapy1 !n !rapy 0 equally useless4 ,b ?is involv$ a huge ov]sight & a mi/ake 9 logic4 ,! !rapy did "w1 z did ! placebo4 ,b :y8 ,! placebo effect has become increas+ly int]e/+ to psy*ological z well z m$ical rese>*]s4 ,app>5tly1 a cli5t's or pati5t's /rong belief 9 ! !rapeutic value ( a process sometimes has a measurable influ5ce on 8 future heal?4 ,! way belief c act 9 ?is way is n necess>ily my/]i\s or my/ical4 ,if we are prep>$ to see emotional difficulties 9 t]ms ( demoralization1 !n belief 9 !rapeutic effectiv5ess is ! mo/ cle>-cut c\nt]balanc+ =ce4 ,/rong belief ( ?is k9d may be en\gh--if ! cli5t really wi%es to *ange & if ! !rapi/ & ! approa* to !rapy toge!r c inspire ! cli5t's confid5ce 9 8 own ability to rega9 control ( 8 life--to help ! cli5t beg9 to lift himself by ! boot/raps4 ,j :at ! necess>y +r$i5ts are to make ?is possible is n yet def9itely kn[n4 ,"s approa*es to !rapy1 h[ev]1 seem to be m successful ?an o!rs 9 inspir+ confid5ce 9 cli5ts ) c]ta9 p]sonality traits & ) c]ta9 goals or problems4 ,! be/ evid5ce = ?is comes f cli5ts !mselves1 ^: evaluations #bgc ( _! own exp]i5ces 9 !rapy we w look at 9 a mom5t4 ,! second bl[ t fell on psy*o!rapy came f ! spontane\s remission critics4 ,aga91 /udies demon/rat$ c]ta9 facts3 99 ,h[ long x takes = spontane\s remission to occur dep5ds greatly on :at sorts ( emotional difficulties cli5ts h4 ,p ) depressive or anxiety reactions t5d1 = example1 to h spontane\s remissions fa/] ?an p]sons ) obsessive-compulsive or hypo*ondriacal symptoms4 99 ,! p]c5tages ( cli5ts :o d exp]i5ce spontane\s remissions are relat$ to ! p]iod ( "t a /udy uses z a basis4 7,! foll[-up p]iods ( diff]5t /udies v>y a great deal1 f mon?s to _m ye>s4 ,z "o rese>*] comm5t$1 ,x is d\btful :e!r life c gu>antee five ye>s ( /ability to any p]son4#ab7 #ab ,eis5bud1 quot$ 9 ,h4 ,h4 ,mosak1 ,problems 9 ! ,def9ition & ,measurem5t ( ,success 9 ,psy*o!rapy1 9 ,w]n] ,wolff & ,joseph ,a4 ,preck]1 eds41 ,success 9 ,psy*o!rapy 7,new ,york3 ,grime ,/ratton1 #aieb71 p4 #ac4 99 ,spontane\s remissions frequ5tly happ5 to cli5ts ^: lives improve because ( =tunate ev5ts1 su* z an improv$ position at "w1 successful m>riages & p]sonal relation%ips1 & p]iods dur+ :i* press+ problems become few] & life m /able4 ,giv5 ^! facts1 spontane\s remission critics argu$ t1 s9ce _m tr\bl$ individuals w get bett] anyway1 )\t psy*o!rapy1 we _c "k t psy*o!rapy caus$ any b5eficial effects4 ,aga91 poor logic4 ,x is l say+ t s9ce c]ta9 bone fractures w ev5tually heal !mselves 9 correct alignm5t1 )\t be+ set 9 a ca/1 we _c "k = ^! cases t a ca/ _h any b5eficial effects4 ,well1 = _m p1 a suitable psy*o!rapy s]ves mu* ! same function z a ca/ does = a brok5 bone3 x supports1 less5s vuln]ability1 r$uces pa91 & makes life a little m com=table until natural heal+ c take place4 ,aga91 :om d we ask to det]m9e :e!r ?is is ! case8 ,we mu/ ask ! p]son ) ! fractur$ arm :e!r ! ca/ made him or h] m com=table4 #bgd ,,h[ ,,psy*o!rapy ,,c ,,be ,,injuri\s ,,to ,,y\r ,,heal? _/ ,is !re sub/antial evid5ce t psy*o!rapi/s sometimes h>m1 z well z b5efit1 _! cli5ts8 ,i ?9k t !re def9itely is & t ?is has be5 fairly well demon/rat$4#ac #ac ,alb]t ,ellis1 ,mu/ ,mo/ ,psy*o!rapi/s ,rema9 z ,incompet5t z ,!y ,n[ ,are81 9 ,j4 ,h>iman1 ed41 ,does ,psy*o!rapy ,really ,help ,p81 p4 #bdj4 ,ev5 love c h>m1 & psy*o!rapy is no exception4 ,ellis id5tifies "s ( ! ma9 ways psy*o!rapi/s c make cli5ts worse3#ad #ad ,ibid41 pp4 #bd-cf4 99 ,!rapi/s may enc\rage cli5ts to be dep5d5t on !m4 ,directly or indirectly a !rapi/ c convey to a cli5t1 ,y _c get along )\t me1 ,y w probably ne$ to sp5d at lea/ two m ye>s 9 !rapy1 etc4 99 ,!rapi/s may ov]emphasize ! significance ( ! cli5t's pa/ exp]i5ce to ! po9t t !y p]suade ! cli5t to feel unju/ifiably weigh$ d[n & controll$ by pa/ ev5ts & circum/ances4 99 ,!rapi/s may become s hook$ on ! importance ( model+ positive p]sonal qualities 7w>m?1 positive reg>d1 congru5ce1 empa?y7 = a cli5t t !y w n provide any active-directive lead]%ip dur+ a "t :5 ! cli5t is fl\nd]+ & ne$s /rong recomm5dations4 99 ,!rapi/s may place too mu* importance on ! role ( insight4 ,! se>* = insight c be nev]-end+4 ,x is useful only to "s cli5ts2 = o!rs1 insight is irrelevant to help+ !m *ange4 99 ,_m !rapi/s feel t !rapy gives cli5ts a *ance to v5t _! feel+s4 ,b ca?>sis by itself is n en\gh to replace de/ructive patt]ns ( behavior & ?9k+ ) con/ructive ones4 99 ,!rapi/s may rely excessively on di/ract+ ! cli5t f issues t tr\ble him2 e4g41 relaxation tra9+1 m$itation1 or !rapeutic ex]cise c help cli5ts break out ( a cycle ( self-preoccupation4 ,self-absorption #bge p]petuates emotional suff]+2 di/ractions c !re=e be invaluable4 ,b if a cli5t's und]ly+ self-defeat+ attitudes are n confront$1 di/raction alone w n be en\gh to br+ ab\t la/+ *ange4 99 ,!rapi/s may rely too heavily on gett+ cli5ts to ?9k positively4 ,positive ?9k+ c und]m9e a cli5t's already %aky confid5ce if he fails to a*ieve ! goals t positive ?9k+ l$ him to expect4 ,^! are und5iable %ortcom+s ( !rapy4 ,!y c r$uce ! effectiv5ess ( !rapy1 or negate its con/ructive effects1 or ev5 cause cli5ts to accept ! !rapi/'s belief t _! condition is worse ?an !y ?\ght & s p]suade !m to feel1 & to be1 ev5 m tr\bl$4 ,x is important to be aw>e ( ^! signs ( :at ,ellis rightly calls incompet5ce 9 !rapi/s4 ,x is also important to realize t psy*o!rapy is n unique 9 hav+ to deal ) pr(essional incompet5ce4 ,physicians c & d fall victim to _m ( ! same excesses3 ne$lessly al>m+ pati5ts1 misdiagnos+ _! conditions1 & sometimes treat+ !m 9 ways t lead to a g5]al wors5+ ( _! heal?4 ,iatrog5esis exi/s 9 m$ic9e z well z 9 psy*o!rapy4 ,until ! day :5 ! _w is a p]fect place1 we simply h to take caveat emptor to he>t--let ! buy] bew>e4 ,a ,ph4,d4 9 cl9ical psy*ology1 c]tification 9 m>riage & family c\nsel+1 or an ,m4,d4 ) specialization 9 psy*iatry un=tunately does n gu>antee aga9/ human fallibility & lack ( wisdom4 ,,:5 ,,psy*o!rapy ,,is ,,successful ,x might be argu$1 !n1 t ! wor? ( psy*o!rapy to ! consum] 7! cli5t7 does n dep5d on its be+ sup]ior to a placebo4 ,:e!r x is or is n sup]ior is a !oretical "q ( int]e/ to !oreticians2 9 judg+ ! practical wor? ( psy*o!rapy1 :at matt]s is consum] satisfaction4 ,judg$ by ! latt] crit]ion1 psy*o!rapy is inde$ wor?:ile4#ae #ae ,edw>d ,erw91 ,is ,psy*o!rapy ,m ,effective ,?an a ,placebo81 9 ,j4 ,h>iman1 ed41 ,does ,psy*o!rapy ,really ,help ,p81 p4 #dh4 #bgf ,!re is a _w ( diff]5ce betwe5 popul>ity & effectiv5ess4 ,is psy*o!rapy only popul> & simply ineffective8 ,all approa*es to !rapy h a built-9 expectation t positive *ange w result4 ,?is belief implicitly is communicat$ to cli5ts1 & x c provide !m ) a s5se ( hope t replaces ! helpless & demoraliz$ /ate t has motivat$ !m to seek !rapy4 ,?is happ5s 9 sev]al ways4 ,= example1 pay+ att5tion to a p]son increases 8 morale & self-e/eem4 ,?is is call$ ! ,haw?orne effect4 ,anyone :o has be5 9 !rapy c appreciate ! gratification t comes f hav+ a compet5t pr(essional give undivid$ att5tion = an h\r4#af ,also1 ! expectation on ! "p ( a !rapi/ t positive results w foll[ itself c influ5ce a cli5t's attitudes & 8 belief t he w get bett]1 t emotional suff]+ w less5 & end4 #af ,james ,o4 ,pro*aska1 ,sy/ems ( ,psy*o!rapy3 ,a ,tran/heoretical ,analysis 7,homewood1 ,,il3 ,! ,dorsey ,press1 #aigi71 p4 #e4 ,! /r5g? ( a cli5t's belief t he c *ange1 t he c improve1 is ! major s+le =ce 9 psy*o!rapy4 ,! cli5t has to feel t 8 belief is w>rant$4 ,_m factors play a role "h3 ! cli5t's education level & ! respect he may feel t[>d ! !rapi/'s tra9+ & exp]i5ce2 ! intangibles ( !rapy--! !rapi/'s integrity1 au!nticity or conv9c+ness1 ! cli5t's s5se t he is und]/ood1 t ! !rapi/ c>es1 t ! !rapi/ himself has le>n$ h[ to cope ) liv+ & c communicate ?is1 etc4 ,psy*o!rapy c be successful :5 ?is s5se ( promise is pres5t 9 !rapy sessions4 ,,cli5ts ,,look ,,back ,i "k myself bett] ?an any doctor c4 ,ovid ,if mo/ emotional difficulties are n illnesses at all b problems ( liv+1 & if problems ( liv+ _c be treat$ m$ically1 !n ! hundr$s ( evaluative /udies ( !rapeutic effectiv5ess h be5 look+ = some?+ t simply is n !re3 an objective /&>d aga9/ :i* to judge !rapeutic #bgg success4 ,x makes v little s5se to speak ( /&>ds 9 connection ) problems ( liv+ t come ab\t f demoralization4 ,! only /&>d we c reasonably appeal to is ! subjective judgm5t ( cli5ts !mselves1 :o h exp]i5c$ p]iods 9 !rapy4 ,!rapy is a purely individual affair & c be measur$ only 9 t]ms ( its mean+ to ! p]son1 *ild1 or adult1 ( its value1 n = happ9ess1 n = virtue1 n = social adju/m5t b = gr[? & developm5t 9 t]ms ( a purely individual norm4#ag #ag ,j4 ,taft1 ,! ,dynamics ( ,!rapy 9 a ,controll$ ,relation%ip 7,new ,york3 ,macmillan1 #aicc71 quot$ 9 ,h4 ,h4 ,mosak1 ,problems 9 ! ,def9ition & ,measurem5t ( ,success 9 ,psy*o!rapy1 9 ,wolff & ,preck]1 eds41 ,success 9 ,psy*o!rapy1 p4 #g4 ,a few repres5tative & specific evaluations ( _! exp]i5ces 9 psy*o!rapy by =m] cli5ts foll[4 ,!y are includ$ "h n z pro( ( ! effectiv5ess ( psy*o!rapy1 because to se>* = objective pro( 9 ?is area is a mi/ake1 b r z illu/rations ( diff]5t ways p believe !mselves to h be5 help$3#ah #ah ,mo/ evaluative /udies ( psy*o!rapy h attempt$ 9 "s way to take into acc\nt ! judgm5t ( cli5ts4 ,"o /udy 9 p>ticul>1 h[ev]1 has made cli5ts' evaluations ( _! exp]i5ces 9 !rapy its ma9 focus1 9 fact1 = a book-l5g? treatm5t4 ,t is ,hans ,h4 ,/rupp1 ,ronald ,e4 ,fox1 & ,k5 ,lessl]1 ,pati5ts ,view ,_! ,psy*o!rapy 7,baltimore3 ,johns ,hopk9s ,press1 #aifi74 ,"s ( ! pati5t evaluations includ$ "h are bas$ on transcripts f ! ,/rupp-,fox-,lessl] /udy2 !y h be5 p>aphras$ & cond5s$ = use "h4 ,aft] be+ 9 !rapy1 ,i h le>n$ to accept myself m easily & believe t _m ( ! p ^: op9ions ab\t me matt] to me also accept me = :at ,i am4 ,i h come to realize t :at ,i h 9 my life1 9 ! way ( my m>riage1 my *ildr51 my "w is :at ,i h decid$ to settle )4 ,x is easi] & m satisfy+ = me to d ?is ?an always to be fight+ ! pres5t & /ra9+ = ?+s ,i hav5't got4 ,i /ill h problems ) my own self-confid5ce4 ,i accept "s volunte] "w at my *ur*1 9 spite ( ^! feel+s ( self-d\bt1 believ+ t ,i really am m5tally capable & feel+ t ,i c1 9 "t1 & ) pati5ce1 ov]come my feel+s ( inadequacy4 #bgh ,i n[ love my daught] )\t qualifications4 ,i h mu* less ho/ility t[>d my "m4 ,i'm mu* less afraid n[ to feel unpleasant emotions & feel less guilt ?an ,i did4 ,i'm n afraid to /& up = myself & say :at ,i feel4 ,i feel m pati5t n[ ) myself & ) o!rs4 ,i lose my temp] mu* less (t54 ,i enjoy life mu* m1 feel m cont5t & happy ov] small ?+s4 ,i'm mu* m aw>e n[ ( ! feel+s ( o!rs4 ,i didn't l be+ ar\nd p4 ,n[ ,i actually c enjoy _! company4 ,ev5 p>ties d n make me n]v\s l !y us$ to4 ,i am less incl9$ to condemn o!rs :5 !y are n l me1 & ,i f9d myself (f]+ sugge/ions & advice less frequ5tly4 ,! greate/ *ange t !rapy has br\ght me has be5 to help me get my confid5ce aga94 ,i h gone ?r\gh p]iods ( grief ?ree times s9ce ,i left !rapy1 :5 memb]s ( my family h di$4 ,i d n feel ,i c\ld h ma9ta9$ a s5se ( balance dur+ ^! times if ,i _h n _h ! exp]i5ce ( !rapy4 ,i feel ,i am bett] able to tru/ my judgm5t n[ & c cope ) liv+ m effectively4 ,i feel bett] ab\t myself1 ?\gh ,i d (t5 /ill feel a s5se ( guilt4 ,my problems hav+ to d ) a /rong fa!r :o has condemn$ ! cli5t because ( h] /yle ( liv+ & has cut (f relations ) h] are /ill ) me1 b ,i feel t ,i h le>n$ to face life m squ>ely & head-on )\t s mu* fe>4 ,i'm sure t !rapy 0 ! mo/ important "p ( ?is *ange4 ,i feel mu* m able to relate to my fussy & neurotic p>5ts4 ,_! d>k moods & bitt]ness don't plunge me into ! dumps l !y us$ to4 ,n[1 :5 ,i d get depress$1 in/ead ( j want+ to give up1 ,i ask myself :at x is t has depress$ me1 & (t5 ,i c reason my way out ( ! negative /ate ,i'm 94 ,i c cope ) responsibilities mu* bett] n[4 ,i h few] d\bts n[ ab\t my abilities4 ,i feel m inn] calm & c cope ) daily problems m easily4 ,i h le>n$ t x doesn't pay = me to be a p]fectioni/ ab\t ev]y?+4 ,i /ill admire my desire = p]fection 9 "s ?+s t are really important to me1 b ,i no long] fuss ) do+ a p]fect job1 = example1 pat*+ ! tra% c4 #bgi ,i've accept$ myself z a homosexual1 & am happy at "w1 & feel productive4 ,i am less anxi\s 9 relation%ips ) o!rs n[4 ,al?\gh ,i /ill feel negative judgm5t f my family1 ,i no long] h suicidal ?\ghts4 ,i realize t ,i %\ld live 9 a way t is true to myself & t o!rs may diff]1 b ,i'm ,,ok myself4 ,i sometimes w give myself a treat1 some?+ ,i nev] us$ to d4 ,i w buy myself some?+ t maybe is a little bit frivol\s1 b ,i ?9k ( ?is z my own !rapy4 ,i feel bett] ab\t myself & d5y myself less4 ,i 0 almo/ a /oical nun be=e4 ,n[ ,i c>e m ab\t myself4 ,i us$ to ?9k t sp5d+ money to h my hair done 0 silly & a wa/e ( money4 ,n[ ,i ?9k t if x makes me feel good ab\t myself1 & ,i want to treat myself to x1 :y n8 ,i us$ to analyze ev]y?+ to ! po9t t ,i didn't enjoy mu* & 0 always ask+ myself1 l ! bump]-/ick]1 am ,i hav+ fun yet8 ,n[1 ,i j let "s ?+s be4 ,x doesn't pay = me to "q ev]y?+ all ! "t4 ,n[1 :5 ,i don't l a p]son1 ,i j accept ?is4 ,i don't feel guilty because ,i c\ldn't see _! bett] side1 & ,i don't feel ho/ile j because = me ! p]son isn't m likable4 ,,:at ,,makes ,,psy*o!rapy ,,successful ,x is n s mu* ! tea*] :o tea*es b ! /ud5t :o le>ns4 ,:e!r or n ! cli5t gets value = fee paid to a psy*o!rapi/ dep5ds l>gely on ! cli5t4 ,don ,diespeck] 9 ,does ,psy*o!rapy ,really ,help ,p8 ,psy*o!rapy is mu* m l education ?an x is l m$ic9e4 ,9 education1 c]ta9 /ud5ts--no m or less intellig5t ?an o!rs--w nev]!less be m successful4 ,!y h well-kn[n *>act]i/ics3 !y are int]e/$ 9 :at ! exp]i5ce ( education c (f] !m1 & !y "w h>d & regul>ly4 ,v mu* ! same ?+ holds true 9 psy*o!rapy3 "s cli5ts simply get m f !rapy ?an o!rs4 ,:y8 ,9 "p x has to d ) h[ well mat*$ a cli5t & ! approa* ( ! #bhj !rapi/ are4 ,9 "p x is ! am\nt ( confid5ce ! cli5t comes to feel t[>d ! !rapi/ z a p]son4 ,beyond ^!1 ! qualities ( a successful cli5t are v simil> to ^? ( a successful /ud5t4 ,specifically1 cli5ts :o h successful exp]i5ces 9 !rapy t5d to %>e ^! *>act]i/ics3 99 ,:ile 9 !rapy1 !y are motivat$ to *ange3 ,!y feel consid]able int]nal pressure to d some?+ to resolve _! problems4 ,!y come to feel a s5se ( initiative & det]m9ation4 ,!y come to believe 9 ! process ( !rapy & feel x c be ( help to !m4 99 ,!y are self-discipl9$4 ,!y keep appo9tm5ts regul>ly1 !y attempt to implem5t ! !rapi/'s recomm5dations1 & !y are less incapacitat$ by _! difficulties ?an o!r cli5ts ) simil> problems4 99 ,!y h a level ( emotional maturity t is high en\gh to )/& "s ( ! pa9ful feel+s or fru/rations !y enc\nt] 9 !rapy4 99 ,frequ5tly !y come to enjoy !rapy4 ,obvi\sly1 a great deal does dep5d on ! !rapi/4 ,& yet1 :ile a good /ud5t c le>n mu* 9 spite ( a poor tea*]1 a poor /ud5t le>ns little f an excell5t tea*]4 ,successful !rapy dep5ds prim>ily on ! cli5t4 ,o!r factors c affect y\r ability to succe$ 9 !rapy1 b ^! are factors ov] :i* y h no control3 99 :e!r y h ! emotional support & sympa?y ( an und]/&+ & tol]ant sp\se or family 99 :e!r y h _h a long hi/ory ( emotional problems 9 connection ) "w & int]p]sonal relations 7deeply +ra9$ habits are h>d] to break7 99 :e!r precipitat+ factors br\ght ab\t y\r pres5t difficulties or !y j appe>$ out ( ! blue 99 h[ long y h _h y\r pres5t problem 99 :at ! problem is3 :e!r x is purely emotional or x has affect$ y\r capacity to ?9k coh]5tly & reali/ically 99 :e!r !re h be5 =tunate or un=tunate ev5ts 9 y\r life be=e & dur+ !rapy #bha ,:at ! future holds 9 /ore = y aft] !rapy relies greatly on _m ( ^! same factors & on _m ( ! p]sonality qualities t help$ y1 or h9d]$ y1 z a cli5t 9 !rapy 7see ,*apt] #ba74 ,,s1 ,,does ,,psy*o!rapy ,,"w8 ,yes1 = c]ta9 cli5ts & "u c]ta9 circum/ances4 ,! ma9 *anges t psy*o!rapies aim = are ei!r to elim9ate de/ructive habits ( ?\ght1 attitude1 or behavior or to e/abli% new1 con/ructive habits4 ,nei!r "o c be accompli%$ by means ( a m$ically effective treatm5t t is appli$ to ! pati5t until a cure occurs4 ,a few emotional problems fall "u ! head+ ( true psy*iatric disord]s & result f physical causes4 ,!y include1 = example1 epilepsy1 drug addiction1 & ,alzheim]'s disease4 ,b ^! conditions are 9 ! m9ority2 mo/ emotional disord]s h n be5 trac$ to und]ly+ organic causes4 ,!re are sev]al curr5tly compet+ hypo!ses relat+ to possible bio*emical bases ( s*izophr5ia1 mania1 depression1 & anxiety disord]s4 ,z "t goes by & m$ical rese>* progresses1 m emotional conditions w v likely be ti$ to und]ly+ physical problems4 ,until t "t1 h[ev]1 !y rema9 m$ically incurable conditions4 ,at pres5t1 ! possibility ( ov]com+ !m dep5ds heavily on cli5ts !mselves1 _! ability to f9d an approa* to !rapy t is appropriate = _! p]sonality & _! goals or problems1 & _! good =tune 9 locat+ a !rapi/ :o is able to help !m to summon ! fai?1 en]gy1 det]m9ation1 & c\rage necess>y to ov]come _! s5se ( demoralization4 #bhb #ba ,,life ,,aft] ,,!rapy ,!oretically1 psy*o!rapy is nev]-end+1 s9ce emotional gr[? c g on z long z "o lives4 ,lewis ,r4 ,wolb]g1 ,! ,te*nique ( ,psy*o!rapy ,x c be difficult to "k :5 to t]m9ate !rapy3 difficult = y1 ! cli5t1 & sometimes also difficult = ! !rapi/4 ,"s p]iods 9 !rapy d n lead to a successful outcome4 ,y may become dissatisfi$ ) ! process ( !rapy or ) ! !rapi/4 ,or1 ! !rapi/ may become disappo9t$ 9 y\r will+ness to "w & to *ange4 ,an impasse may be rea*$ :]e x seems no progress c be made4 ,:5 ?is happ5s1 x c be h>d to "k :5 to draw a l9e1 to say3 ,we've tri$1 b we h to face ! fact t we're n gett+ any:]e4 ,b sometimes ?is has to be said1 & !n y may decide to look else:]e = help4 ,on ! o!r h&1 :5 y\r !rapy has be5 successful & has l$ to cle>1 con/ructive results1 x may also be difficult to "k :5 to /op4 ,to mo/ cli5ts1 :at t5ds to be mo/ important is relief f symptoms4 ,:5 ?is is a*iev$1 y may be tempt$ to t]m9ate4 ,b relief f tr\bl+ symptoms is n always a sign t problems h be5 resolv$4 #bhc ,frequ5tly1 relief f di/ress comes ab\t because ( problem avoidance4 ,y may h /ructur$ y\r life 9 a way t circumv5ts1 r ?an faces1 ! ?+s t tr\ble y4 ,!re are times :5 ?is is inde$ ! be/ solution4 ,h[ev]1 ! t5d5cy is = cli5ts to associate relief ) effective !rapy1 & (t5 ?is is n ! case4 ,! !rapi/1 on ! o!r h&1 may h c]ta9 p]sonal values t he wi%es to satisfy be=e end+ !rapy ) y3 he may favor1 = example1 qualities ( ass]tiv5ess & ambiti\sness 7or qualities ( submissiv5ess & compliance71 want y to develop ^! traits1 & feel reluctant to end !rapy until y h done ?is4 ,9 g5]al1 ! decision to t]m9ate !rapy %\ld be made ) a numb] ( objectives 9 m9d3 99 ,h y\r tr\bl+ symptoms disappe>$ or at lea/ be5 r$uc$ to a level t is tol]able8 99 ,h y improv$ y\r und]/&+ ( y\rself s t y feel a heal?y measure ( self-acceptance8 99 ,d y n[ h a great] tol]ance to fru/ration8 99 ,h y develop$ reali/ic life goals8 99 ,are y able to function relatively well 9 social gr\ps8 99 ,are y bett] able to enjoy life & "w8 ,^! goals ne$ always to be temp]$2 !y all involve comp>ative judgm5ts t %\ld take into acc\nt :]e y />t$ & :at y h accompli%$4 ,!re is no p]fection "h1 only degrees ( adju/m5t1 compromise1 & a will+ness to accept y\rself z a mixture ( human weaknesses & /r5g?s4 444 ,we h to cont5t ourselves ) ! mode/ objective ( fre$om f di/urb+ symptoms1 ! capacity to function reasonably well1 & to exp]i5ce a modicum ( happ9ess 9 liv+4#a #a ,lewis ,r4 ,wolb]g1 ,! ,te*nique ( ,psy*o!rapy1 vol4 #b1 p4 #gdg4 ,,fac+ ,,relapses ,"s !rapi/s believe t !rapy _c be call$ successful until y h _h a relapse & h be5 able to get #bhd ?r\gh x on y\r own4 ,%ad[s ( old habits l+] on4 ,!y are especially likely to resurface dur+ p]iods ( insecurity1 disappo9tm5t1 & fru/ration4 ,!y repres5t a "p ( y--p]haps a "p y w\ld j z soon 7 n !re1 b a "p ( y1 none!less1 t y _c expect to eradicate completely4 ,y are mu* bett] prep>$ to face ! *all5ges ( ! future1 ( ev5ts t _c be anticipat$1 & ( unc]ta9ties t _c be avoid$1 if y d n dem& a total *ange 9 y\rself to ! po9t t old reactions nev] recur4 ,y are bett] prep>$ if y realize t x is likely "s w return = brief visits dur+ p]iods ( p>ticul> /ress4 ,if & :5 ?is happ5s1 y c r5d] ^! visits less di/ress+ & less able to ?r[ y by us+ ! und]/&+ y h ga9$ f !rapy4 ,y are apt to get a flurry ( anxiety & a return ( symptoms f "t to "t4 ,don't be upset or intimidat$ by ?is4 ,! be/ way to h&le y\rself is fir/ to realize t y\r relapse is self-limit$4 ,x w ev5tually come to a halt4 ,no?+ t]rible w happ5 to y4 ,second1 ask y\rself :at has be5 go+ on4 ,try to figure out :at creat$ y\r upset1 :at ar\s$ y\r t5sion4 ,relate ?is to ! g5]al patt]ns t y h be5 pursu+4444 ,old habits hold on1 b !y w ev5tually get less & less provok+4#b #b ,wolb]g1 ,! ,te*nique ( ,psy*o!rapy1 vol4 #b1 p4 #ged4 ,,h[ ,,to ,,c>ry ,,on ,!rapy is a tempor>y crut* or a ca/ 9 :i* to heal1 a com=t1 a s\rce = r5ew$ fai? 9 y\rself1 & an exp]i5ce ( le>n+4 ,x _c solve all ! problems ( future liv+1 = ^! pose new *all5ges t require ( u all t we readju/ our goals & expectations1 become m resili5t & less easily tr\bl$ or brok54 7,! flexible bamboo is m likely to survive a /orm ?an ! mighty oak47 ,r$uc+ an individual's rigidity is an objective ( all psy*o!rapies4 ,becom+ less rigid all[s y to accommodate to *anges & to tol]ate ext]nal /ress m easily4 ,decreas$ rigidity helps y adju/ to new dem&s plac$ on y by y\r surr\nd+s4 #bhe ,b !re is ano!r side to liv+ successfully1 & t is1 fir/1 ! ability to recognize situations & circum/ances t cause y excessive /ress &1 second1 ! will+ness to leave !m be=e x is too late4 ,we t5d to place all ( ! responsibility = adju/m5t to /ress on ourselves1 on our inn] /r5g?s4 ,b (t5 ?is is unnecess>y1 unreasonable1 & ev5 self-de/ructive4 ,(t5 x is ! situation t is n desirable or tol]able1 n a weakness 9 ourselves 9 be+ unable to cope ) x4 ,x c sometimes take m /r5g? & c\rage to break free f a patt]n ( fru/ration & unhapp9ess ?an to rema9 on1 sl[ly we>+ d[n y\r res\rces & gr[+ old] fa/4 ,mu* ( successful liv+ aft] !rapy is a matt] ( prev5tion3 ( be+ aw>e :5 y beg9 to tax y\rself m ?an y ne$ to1 :5 y\r body & m9d beg9 to tell y t y are develop+ new habits ( anxiety or depression or are />t+ to re9=ce old ones4 ,at ^! times1 take /ock ( :at y are do+1 ( h[ y\r daily liv+ may be 9 conflict ) y\r values & attitudes4 ,prev5tion "h means be+ will+ to *ange an undesirable situation1 n j endur+ x :ile try+ to *ange its consequ5ces 9 y4 ,?is is l>gely a matt] ( kn[+ & respect+ y\rself1 ( n requir+ y\rself to accept conditions t y feel w lead y to grief4 ,!rapy may help y tol]ate /ress m easily1 b ?is is "o-sid$ if y d n also le>n to protect y\rself f /ress t is excessive4 7,ev5 bamboos c be brok547 ,!rapy is an opportunity = y to le>n h[ to cope bett] ) ! problems ( liv+4 ,y le>n t y c face ! dem&s ( life successfully 9 ^! ways3 99 ?r\gh belief 9 y\rself & ?r\gh /r5g? ( w 99 by dim9i%+ y\r preoccupation ) y\rself & develop+ int]e/s outside y\rself 99 by und]/&+ y\r reactions & accept+ !m r ?an fight+ y\rself 99 by liv+ 9 ! pres5t 99 by tak+ y\rself less s]i\sly1 by develop+ a s5se ( humor & p]spective ,hav+ le>n$ ^! ?+s1 y !n simply d ! be/ y c )9 ! limitations ( life4 #bhg ,,"p ,,iv ,,app5dixes #bhi ,n4,b4 ,s9ce ! fir/ edition ( ?is book1 ! majority ( ! gr\ps & organizations li/$ 9 ! foll[+ app5dix may be readily contact$ by e-mail4 ,= curr5t e-mail addresses1 ,google ! names ( any organizations y wi% to contact4 ,,app5dix ,a3 ,ag5cies & ,organizations ,t ,c ,help 7,unit$ ,/ates & ,canada7 ,,"p ,i3 ,,unit$ ,,/ates ,,self-,,help ,,organizations ,= ,g5]al ,in=mation ,self-help gr\ps exi/ = _m diff]5t k9ds ( problems4 ,!y are li/$ 9 _m communities by local bran*es ( ! ,self-,help ,cle>+h\se4 ,if a bran* is n li/$ 9 y\r telephone directory & y w\ld l a li/+ ( self-help gr\ps 9 y\r area1 contact3 ,national ,self-,help ,cle>+h\se #be ,w4 #dcrd ,/4 ,new ,york1 ,,ny #ajjcf 7#bab7 #hdj-abei ,a fact %eet on self-help gr\ps prep>$ by ! ,national ,in/itute ( ,m5tal ,heal? is available at no *>ge f3 ,consum] ,in=mation ,c5t] ,dep>tm5t #fji,k ,pueblo1 ,,co #hajji #bij ,also1 y may wi% to contact3 ,national ,self-,help ,res\rce ,c5t] #agbi-ca ,connecticut ,ave41 ,,nw ,wa%+ton1 ,,dc #bjjji 7#bjb7 #chg-jaid ,= a detail$ guide to self-help gr\ps1 consult ,,help3 ,a ,work+ ,guide to ,self-,help ,gr\ps1 by ,alan ,g>tn] & ,frank ,riessman 7,new ,york3 ,new ,viewpo9ts_/,vision ,books1 #aihj74 ,= ,specific ,problems ,= alcoholics3 ,alcoholics ,anonym\s ,_w ,s]vices ,,po ,box #dei1 ,gr& ,c5tral ,/ation ,new ,york1 ,,ny #ajafc 7#bab7 #fhf-aajj ,= families ( alcoholics3 ,al-,anon ,family ,gr\p ,headqu>t]s #a ,p>k ,ave4 ,new ,york1 ,,ny #ajjaf 7#bab7 #fhc-agga ,= individuals ) emotional problems3 ,emotions ,anonym\s ,int]national #aeie ,selby ,ave4 ,/4 ,paul1 ,,mn #eeajd 7#fab7 #fdg-igab ,neurotics ,anonym\s #cfcf #af? ,/41 ,,nw ,wa%+ton1 ,,dc #bjjje 7#bjb7 #fbh-dcgi ,= individuals :o h be5 treat$ = emotional or m5tal difficulties3 ,recov]y1 ,inc4 #hjb ,n4 ,de>born ,/4 ,*icago1 ,,il #fjfjc 7#cab7 #ccg-effa #bia ,national ,alliance = ! ,m5tally ,ill #aija ,n4 ,=t ,my] ,dr4 ,/e4 #ejj ,arl+ton1 ,,va #bbbji 7#gjc7 #ebd-gfjj ,autism3 ,national ,society = ,auti/ic ,*ildr5 ,in=mation ,ref]ral ,s]vice #abcd ,massa*usetts ,ave41 ,,nw ,wa%+ton1 ,,dc #bjjje 7#bjb7 #ghc-jabe ,epilepsy3 ,epilepsy ,f\ndation ( ,am]ica #dcea ,g>d5 ,city ,dr4 ,l&ov]1 ,,md #bjghe 7#cja7 #dei-cgjj ,le>n+ disord]s3 ,c\ncil = ,exceptional ,*ildr5 #aibj ,association ,dr4 ,re/on1 ,,va #bbjia 7#gjc7 #fbj-cffj ,= families :o h *ildr5 ) behavior problems3 ,families ,anonym\s ,,po ,box #ebh ,van ,nuys1 ,,ca #iadbf 7#hah7 #ihi-ghda ,= s+le p>5ts ) *ildr53 ,p>5ts ,)\t ,p>tn]s ,int]national #giaj ,woodmont ,ave4 ,wa%+ton1 ,,dc #bjjad 7#cja7 #fed-hhej ,= p>5ts ( abus$ *ildr53 ,p>5ts ,anonym\s #gabj ,frankl9 ,ave4 ,los ,angeles1 ,,ca #ijjdf 7#bac7 #hgf-ifdb #bib ,= pa?ological gambl]s3 ,gambl]s ,anonym\s ,,po ,box #agagc ,los ,angeles1 ,,ca #ijjag 7#bac7 #chf-hghi ,= families ( pa?ological gambl]s3 ,gam-,anon ,,po ,box #dedi ,d[ney1 ,,ca #ijbda 7#bac7 #dfi-bgea ,= individuals ) phobias3 ,,t]rap #ajaj ,doyle ,/4 ,m5lo ,p>k1 ,,ca #idjbe 7#dae7 #cbi-abcc ,= obesity3 ,ov]eat]s ,anonym\s #baij ,w4 #aij? ,/4 ,torrance1 ,,ca #ijejd 7#bac7 #cbj-gida ,weight ,wat*]s ,int]national #hjj ,community ,dr4 ,manhasset1 ,,ny #aajcj 7#eaf7 #fbg-ibjj ,= n>cotics addicts3 ,n>cotics ,anonym\s #hjfa ,v9el& ,ave4 ,sun ,valley1 ,,ca #iaceb 7#bac7 #gfh-fbjc ,national ,association on ,drug ,abuse ,problems #afj ,n4 ,frankl9 ,hemp/ead1 ,,ny #aaeej 7#eaf7 #dha-jbbj #bic ,,pr(essional ,,associations ,am]ican ,academy ( ,psy*oanalysis #cj ,e4 #dj? ,/4 ,new ,york1 ,,ny #ajjaf 7#bab7 #fgi-daje ,am]ican ,association = ,m>riage & ,family ,!rapy #agag ,k ,/41 ,,nw ,suite #djg ,wa%+ton1 ,,dc #bjjjf 7#bjb7 #dbi-ahbe ,am]ican ,association ( ,sex ,educators1 ,c\nselors & ,!rapi/s #aa ,dupont ,circle1 ,,nw ,suite #bbj ,wa%+ton1 ,,dc #bjjcf 7#bjb7 #dfb-aaga ,am]ican ,psy*iatric ,association #adjj ,k ,/41 ,,nw ,wa%+ton1 ,,dc #bjjje 7#bjb7 #fhb-fjjj ,am]ican ,psy*ological ,association #abjj #ag? ,/41 ,,nw ,wa%+ton1 ,,dc #bjjcf 7#bjb7 #iee-gfhf ,association = ,advancem5t ( ,behavioral ,!rapy #ae ,w4 #cf? ,/4 ,new ,york1 ,,ny #ajjaa 7#bab7 #bgi-gigj ,national ,association ( ,social ,work]s #giha ,ea/]n ,ave4 ,silv] ,spr+1 ,,md #bjijg 7#cja7 #efe-jccc #bid ,,"p ,,ii3 ,,canada ,,self-,,help ,,organizations ,= ,g5]al ,in=mation ,! ,c5tre = ,s]vice to ! ,public publi%es ! annual ,index to ,f$]al ,programs ,s]vices1 :i* conta9s descriptions ( m ?an #a1ajj programs & s]vices adm9i/]$ by f$]al dep>tm5ts1 ag5cies1 & ,cr[n ,corporations4 ,! ,c5tre also op]ates ! ,canada ,s]vice ,bureaus ?r\gh\t ,canada1 :i* provide telephone ref]ral s]vices = individuals int]e/$ 9 locat+ f$]al ag5cies & programs4 ,contact3 ,c5tre = ,s]vice to ! ,public #cfe ,lauri] ,ave41 ,w4 ,ottawa1 ,,on ,kl,a #j,s#e 7#fac7 #iic-fcdb ,also1 y may wi% to contact3 ,dep>tm5t ( ,national ,heal? & ,welf>e ,social ,s]vice ,programs ,bran* ,national ,welf>e ,grants ,program1 #g? fl4 ,brooke ,claxton ,build+ ,tunney's ,pa/ure ,ottawa1 ,,on ,k#a;,a #a;,b#e 7#fac7 #iij-iefc ,canadian ,m5tal ,heal? ,association #bafj ,yonge ,/4 ,toronto1 ,,on ,m#d,s #b,z#c 7#daf7 #dhd-ggej ,= in=mation ab\t community s]vices1 contact3 ,volunt>y ,action ,dep>tm5t ( ,secret>y ( ,/ate #ae ,eddy ,/41 ,hull ,ottawa1 ,,on ,k#a;,a ,,om#e 7#hai7 #iid-bbee #bie ,= ,specific ,problems ,= alcoholics3 ,alcoholics ,anonym\s ,int]gr\p ,(fice #bgb ,egl9ton ,ave41 ,w4 ,toronto1 ,,on ,m#d,r #a;,b#b 7#daf7 #dhg-eeia ,,addics 7,alcohol ,drug ,dep5d5cy ,in=mation ,c\nsell+ ,s]vices7 #hah ,portage ,ave41 #bji ,w9nipeg1 ,,mb ,r#c;,g #j,n#d 7#bjd7 #gge-abcc ,= individuals :o are m5tally or physically disabl$3 ,disabl$ ,peoples' ,int]national 7,,dpi7 #bjg-bid ,portage ,ave4 ,w9nipeg1 ,,mb ,r#c;,c #a,k#b 7#bjd7 #idb-cfjd ,= individuals :o h be5 treat$ = emotional or m5tal difficulties3 ,m5tal ,pati5ts ,association #badf ,yew ,/4 ,vanc\v]1 ,,bc ,v#f,k #c;,g#g 7#fjd7 #gch-eagg ,autism3 ,autism ,society ,canada ,box #dgb1 ,/a4 ,a ,sc>bor\gh1 ,,on ,m#a,k #e;,c#c 7#daf7 #ddd-hebh ,epilepsy3 ,epilepsy ,ont>io #bafj ,yonge ,/41 #a/ fl4 ,toronto1 ,,on ,m#d,s #b;,a#i 7#daf7 #dhi-bhbe #bif ,le>n+ disord]s3 ,canadian ,association = ,*ildr5 & ,adults ) ,le>n+ ,disabilities #cbc ,*apel ,/4 ,ottawa1 ,,on ,k#a,n #g,z#b 7#fac7 #bch-egba ,= families :o h *ildr5 ) emotional & behavior problems3 ,ont>io ,association ( ,*ildr5's ,m5tal ,heal? ,c5tres #dj ,/4 ,clair ,ave41 ,e41 #cji ,toronto1 ,,on ,m#d,t #a,m#i 7#daf7 #iba-baji ,= s+le p>5ts ) *ildr53 ,"o ,p>5t ,families ,association ( ,canada #bbgi ,yonge ,/41 #ag ,toronto1 ,,on ,m#d,p #b;,c#g 7#daf7 #dhg-gigf ,= n>cotics addicts3 ,,addics 7,alcohol ,drug ,dep5d5cy ,in=mation ,c\nsel+ ,s]vices7 #hah ,portage ,ave41 #bji ,w9nipeg1 ,,mb ,r#c;,g #j,n#d 7#bjd7 #gge-abcc ,,pr(essional ,,associations ,canadian ,psy*iatric ,association #bbe ,lisg> ,/41 #ajc ,ottawa1 ,,on ,k#b,p #j;,c#f 7#fac7 #bcd-bhae ,canadian ,psy*oanalytic ,society #gjjj ,cte des ,neiges ,rd4 ,montreal1 ,,qc ,h#c,s #b;,c#a 7#ead7 #gch-faje #big ,canadian ,psy*ological ,association #eeh ,k+ ,edw>d ,ave4 ,ottawa1 ,,on ,k#a,n #g,n#f 7#fac7 #bch-ddji ,c\ncil ( ,prov9cial ,associations ( ,psy*ology #eeh ,k+ ,edw>d ,ave4 ,ottawa1 ,,on ,k#a,n #g,n#f 7#fac7 #bch-ddji ,ont>io ,psy*ological ,association #adjg ,yonge ,/41 #djb ,toronto1 ,,on ,m#d,t #a,y#g 7#daf7 #ifa-eeeb ,ont>io ,association = ,m>riage & ,family ,!rapy #bga ,russell ,hill ,rd4 ,toronto1 ,,on ,m#d,v #b,t#e 7#daf7 #ifh-gggi ,canadian ,association ( ,social ,work]s #ee ,p>kdale ,ave41 #cl#f ,ottawa1 ,,on ,k#a,y #a;,e#e 7#fac7 #gbh-ahfe ,corporation ,pr(essionnelle des ,travailleurs ,sociaux du ,quebec #egeg ,decelles ,ave41 ,*4 #cce ,montreal1 ,,qc ,h#c,s #b;,c#c 7#ead7 #gca-bgdi ,canadian ,guidance ,c\nsel+ ,association ,faculty ( ,education ,univ]sity ( ,ottawa #fea ,cumb]l& ,/41 ,rm4 #dbg ,ottawa1 ,,on ,k#a,n #f,n#e 7#fac7 #bcd-begb #bih ,,app5dix ,b3 ,sugge/ions = ,fur!r ,read+ ,,g5]al ,,in=mation ,gre5b]g1 ,bette4 ,h[ to ,f9d ,out 9 ,psy*iatry3 ,a ,guide to ,s\rces ( ,m5tal ,heal? ,in=mation4 ,new ,york3 ,p]gamon ,press1 #aigh4 ,p[ell1 ,b>b>a ,j4 ,a ,layman's ,guide to ,m5tal ,heal? ,problems & ,treatm5ts4 ,spr+field1 ,,il3 ,*>les ,c4 ,?omas1 #aiha4 ,russell1 ,b]tr&4 ,! ,conque/ ( ,happ9ess4 ,new ,york3 ,bantam1 #aifh 7fir/ publi%$ 9 #aicj74 ,"o ( ! mo/ psy*ologically p]ceptive attempts to id5tify ! basic +r$i5ts = a happy life1 by a philosoph] :o made orig9al contributions to :atev] subjects he t\*$4 ,/rupp1 ,hans ,h4 ,pati5ts ,view ,_! ,psy*o!rapy4 ,baltimore3 ,johns ,hopk9s ,press1 #aifi4 ,evaluations by pati5ts ( _! exp]i5ces 9 psy*o!rapy4 ------4 ,psy*o!rapi/s 9 ,action4 ,new ,york3 ,grune ,/ratton1 #aifj4 ,focuses on :at ! !rapi/ actually does 9 ! !rapy relation%ip4 ,watson1 ,rob]t ,i41 ,jr4 ,psy*o!rapies3 ,a ,comp>ative ,casebook4 ,new ,york3 ,holt1 ,re9h>t & ,w9/on1 #aigg4 ,a collection #bii ( cases treat$ by means ( diff]5t approa*es to psy*o!rapy4 ,:eelis1 ,all54 ,h[ ,p ,*ange4 ,new ,york3 ,h>p] ,r[1 #aigc4 ,an insightful book ab\t ! process ( !rapy4 ,a4 ,,psy*oanalysis 7,,*apt] #i7 ,br5n]1 ,*>les4 ,an ,elem5t>y ,textbook ( ,psy*oanalysis4 ,new ,york3 ,int]national ,univ]sities ,press1 #aigc4 ,a _w-fam\s introduction to analysis t has n[ be5 translat$ into n9e languages4 ,hall1 ,calv94 ,a ,prim] ( ,freudian ,psy*ology4 ,new ,york3 ,new ,am]ican ,libr>y1 #aied4 ,p]haps ! cle>e/ & mo/ concise summ>y ( psy*oanalytic concepts4 ,jones1 ,erne/4 ,! ,life & ,"w ( ,sigmund ,freud4 ,new ,york3 ,basic ,books1 #aiec-eg4 #c volumes4 ,a biography ( ,freud t describes 8 p]sonal developm5t & summ>izes 8 ma9 contributions4 ,b4 ,,cli5t-,,c5t]$ ,,!rapy 7,,*apt] #aj7 ,rog]s1 ,c>l ,ronsom4 ,cli5t-,c5t]$ ,!rapy4 ,bo/on3 ,h\ghton ,miffl91 #aiea4 ,a good introduction to ,rog]s's approa* to !rapy4 ,x 0 8 fir/ major exposition ( 8 !ory4 ------4 ,on ,becom+ a ,p]son3 ,a ,!rapi/'s ,view ( ,psy*o!rapy4 ,bo/on3 ,h\ghton ,miffl91 #aifa4 ,p]haps ,rog]s's be/-kn[n book4 ,x gives a v p]sonal view ( 8 approa*4 ,c4 ,,ge/alt ,,!rapy 7,,*apt] #aj7 ,pagan1 ,j41 & ,i4 ,l4 ,%ep]d1 eds4 ,ge/alt ,!rapy ,n[4 ,palo ,alto3 ,sci5ce & ,behavior ,books1 #aigj4 ,new ,york3 ,h>p] & ,r[1 #aiga4 ,a collection ( articles on ,ge/alt !ory1 te*nique1 & applications by well-kn[n ,ge/alt !rapi/s4 ,p]ls1 ,fr$]ick ,s4 ,ge/alt ,!rapy ,v]batim4 ,moab1 ,,ut3 ,real ,p ,press1 #aife4 ,probably ! mo/ widely read ( ,p]ls's books illu/rat+ ! ,ge/alt approa*4 #cjj ,d4 ,,transactional ,,analysis 7,,*apt] #aj7 ,b]ne1 ,eric4 ,games ,p ,play4 ,new ,york3 ,grove ,press1 #aifd4 ,a simply writt5 summ>y ( ! ma9 concepts ( ,,ta3 ego /ates1 transactions1 games1 etc4 ------4 ,:at ,d ,y ,say ,aft] ,y ,say ,hello8 ,new ,york3 ,grove ,press1 #aigb4 ,publi%$ aft] ,b]ne's dea?1 ?is is an outl9e ( 8 approa* to !rapy1 focus+ on 8 notion ( life scripts4 ,e4 ,,rational-,,emotive ,,!rapy 7,,*apt] #aj7 ,ellis1 ,alb]t4 ,humani/ic ,psy*o!rapy3 ,! ,rational-,emotive ,approa*4 ,new ,york3 ,mc,graw-,hill1 #aigc4 ,a cle> /atem5t ( ! way p c *oose to make1 or n make1 !mselves emotionally di/urb$4 ------1 & ,rob]t ,a4 ,h>p]4 ,a ,new ,guide to ,rational ,liv+4 ,englewood ,cliffs1 ,,nj3 ,pr5tice ,hall1 #aige4 ,"o ( ! be/-kn[n self-help books deal+ ) rational-emotive !rapy4 ,f4 ,,exi/5tial-,,humani/ic ,,!rapy 7,,*apt] #aj7 ,arbuckle1 ,d4 ,c\nsel+ & ,psy*o!rapy3 ,an ,exi/5tial-,humani/ic ,view4 ,bo/on3 ,allyn ,bacon1 #aige4 ,a good introduction to ?is approa* to !rapy4 ,b9swang]1 ,ludwig4 ,be+-9-!-,_w3 ,select$ ,pap]s ( ,ludwig ,b9swang]4 ,new ,york3 ,basic ,books1 #aifc4 ,a less readable book t nev]!less gives ! read] a s5se ( h[ exi/5tialism has be5 appli$ to psy*o!rapy4 ,may1 ,rollo1 ,ern/ ,angel1 & ,h5ri ,ell5b]g]1 eds4 ,exi/5ce4 ,new ,york3 ,basic ,books1 #aieh4 ,a collection ( essays deal+ ) basic topics ( exi/5tial-humani/ic psy*o!rapy4 ,g4 ,,logo!rapy 7,,*apt] #aa7 ,frankl1 ,victor4 ,man's ,se>* = ,mean+3 ,an ,introduction to ,logo!rapy4 ,new ,york3 ,wa%+ton ,squ>e ,press1 #aiei4 ,a cle> & gripp+ description ( ! developm5t ( logo!rapy z a result ( conc5tration camp suff]+4 #cja ------4 ,! ,doctor & ! ,s\l4 ,new ,york3 ,knopf1 #aifc4 ,a fur!r description ( logo!rapy4 ,h4 ,,reality ,,!rapy 7,,*apt] #aa7 ,glass]1 ,william4 ,reality ,!rapy4 ,new ,york3 ,h>p] & ,r[1 #aife4 ,glass] describes 8 view t1 because ( lonel9ess & feel+s ( inadequacy1 p t5d to refuse to take responsibility = fulfill+ _! ne$s = love & wor?4 ,see also ,glass]'s book1 ,positive ,addiction1 li/$ "u ,t4 ,!rapeutic ,ex]cise4 ,i4 ,,adl]ian ,,!rapy 7,,*apt] #aa7 ,adl]1 ,alfr$4 ,problems ( ,neurosis3 ,a ,book ( ,case-,hi/ories4 ,new ,york3 ,h>p] ,tor*books1 #aifd 7fir/ publi%$ 9 #aibi74 ,^! are case examples illu/rat+ ,adl]'s !ory ( neurotic developm5t4 ,! book conta9s an introduction by ,h4 ,l4 ,ansba*] t summ>izes basic ,adl]ian !ory4 ------4 ,social ,int]e/3 ,a ,*all5ge to ,mank9d4 ,new ,york3 ,capricorn ,books1 #aifd 7fir/ publi%$ 9 #aibi74 ,?is is ! la/ exposition giv5 by ,adl] ( 8 ?\ght4 ,x is a good & simply writt5 summ>y ( ,adl]ian psy*ology4 ,j4 ,,bio5]getics 7,,*apt] #aa7 ,keleman1 ,s4 ,sexuality1 ,self & ,survival4 ,san ,francisco3 ,lode/> ,press1 #aiga4 ,l[51 ,alex&]4 ,! ,betrayal ( ! ,body4 ,new ,york3 ,colli]1 #aifg4 ,k4 ,,primal ,,!rapy 7,,*apt] #aa7 ,janov1 ,ar?ur4 ,! ,anatomy ( ,m5tal ,illness3 ,! ,sci5tific ,basis ( ,primal ,!rapy4 ,new ,york3 ,g4 ,p4 ,putnam1 #aiga4 ------4 ,primal ,scream4 ,new ,york3 ,dell1 #aiga4 #cjb ,l4 ,,implosive ,,!rapy 7,,*apt] #aa7 ,/ampfl1 ,?omas ,g41 & ,d4 ,levis4 ,implosive ,!rapy3 ,!ory & ,te*nique4 ,morri/[n1 ,,nj3 ,g5]al ,le>n+ ,press1 #aigc4 ,m4 ,,direct ,,decision ,,!rapy 7,,*apt] #aa7 ,gre5wald1 ,h>old4 ,decision ,!rapy4 ,new ,york3 ,pet] ,h4 ,wyd51 #aigc4 ------1 & ,elizabe? ,ri*4 ,! ,happy ,p]son4 ,new ,york3 ,/e9 & ,day1 #aihd4 ,a v readable summ>y ( direct decision !rapy4 ,n4 ,,c\nt]-,,condition+ 7,,*apt] #ab7 ,o4 ,,behavior ,,modification 7,,*apt] #ab7 ,p4 ,,cognitive ,,approa*es ,,to ,,behavior ,,*ange 7,,*apt] #ab7 ,alb]ti1 ,r4 ,e41 & ,m4 ,l4 ,emmons4 ,/& ,up1 ,speak ,out1 ,talk ,back4 ,new ,york3 ,pocket ,books1 #aige4 ,on ass]tiv5ess tra9+4 ,burns1 ,david4 ,feel+ ,good3 ,! ,new ,mood ,!rapy4 ,new ,york3 ,signet1 #aihj4 ,a good self-help acc\nt ( ! g5]al cognitive approa* to behavior *ange4 ,kanf]1 ,f4 ,h41 & ,a4 ,p4 ,gold/e91 eds4 ,help+ ,p ,*ange4 ,new ,york3 ,p]gamon ,press1 #aige4 ,?is l>ge book discusses op]ant1 cognitive *ange1 & self-control me?ods4 ,! emphasis is on h[ ^! te*niques ( behavior *ange are us$ 9 a cl9ical sett+4 ,wolpe1 ,joseph4 ,! ,practice ( ,behavior ,!rapy4 ,new ,york3 ,p]gamon ,press1 #aigc4 ,"o ( ! major contributors to behavioral psy*o!rapy describes ! use ( te*niques to enc\rage behavior *ange4 ,q4 ,,gr\p ,,!rapy 7,,*apt] #ac7 ,grotjahn1 ,m>t91 ,frank ,m4 ,kl9e1 & ,claude ,t4 ,h4 ,fri$man1 eds4 ,h&book ( ,gr\p ,!rapy4 ,new ,york3 ,van ,no/r&1 #aihc4 ,helm]+1 ,doris ,w4 ,gr\p ,!rapy3 ,:o ,ne$s ,x8 ,millbrae1 ,,ca3 ,cele/ial ,arts1 #aigf4 ,a good in=mal summ>y ( gr\p !rapy4 #cjc ,r4 ,,m>riage ,,!rapy 7,,*apt] #ad7 ,s4 ,,family ,,!rapy 7,,*apt] #ad7 ,fay1 ,all54 ,mak+ ,?+s ,bett] by ,mak+ ,!m ,worse4 ,new ,york3 ,haw?orne ,books1 #aigh4 ,a v>iety ( applications ( !rapeutic p>adoxical /rategies 9 m>riage communication1 z well z 9 connection ) ! treatm5t ( anxiety1 depression1 fe>s1 etc4 ,foley1 ,v9c5t ,d4 ,an ,introduction to ,family ,!rapy4 ,new ,york3 ,grune ,/ratton1 #aigd4 ,haley1 ,jay1 ed4 ,*ang+ ,families3 ,a ,family ,!rapy ,read]4 ,new ,york3 ,grune ,/ratton1 #aiga4 ,watzlawick1 ,paul1 ,john ,weakl&1 & ,ri*>d ,fis*4 ,*ange3 ,pr9ciples ( ,problem ,=mation & ,problem ,resolution4 ,new ,york3 ,norton1 #aigd4 ,a readable & ent]ta9+ description ( ! t5d5cy ( family & m>riage sy/ems to resi/ *ange & a good explanation ( ! use ( p>adoxical /rategies to enc\rage con/ructive *ange4 ,t4 ,,!rapeutic ,,ex]cise 7,,*apt] #ae7 ,fixx1 ,james ,f4 ,! ,complete ,book ( ,runn+4 ,new ,york3 ,r&om ,h\se1 #aigg4 ,see ,*apt] #b1 ,:at ,happ5s to ,y\r ,m9d4 ,glass]1 ,william4 ,positive ,addiction4 ,new ,york3 ,h>p] & ,r[1 #aigf4 ,glass] proposes t "s activities su* z runn+ & m$itation are positive addictions2 _! practice c help a p]son gr[ emotionally /rong]4 ,glov]1 ,bob1 & ,jack ,%eph]d4 ,! ,runn]'s ,h&book4 ,new ,york3 ,vik+ ,press1 #aigg4 ,see ,*apt] #ae1 ,/ress & ,t5sion1 & ,*apt] #af1 ,runn+ ,inside ,y\r ,head4 ,ko/rubala1 ,?addeus4 ,! ,joy ( ,runn+4 ,philadelphia3 ,j4 ,b4 ,lipp9cott1 #aigf4 ,see ,*apt]s #f1 #g1 & #h on ,psy*ological ,effects1 ,!ory1 & ,runn+ & ,!rapy4 ,u4 ,,bi(e$back 7,,*apt] #ae7 ,br[n1 ,b4 ,b4 ,/ress & ! ,art ( ,bi(e$back4 ,new ,york3 ,h>p] & ,r[1 #aigg4 ,reviews ! effectiv5ess ( bi(e$back4 ,weiss1 ,anne ,e4 ,bi(e$back3 ,fact or ,fad8 ,new ,york3 ,frankl9 ,watts1 #aihd4 ,a cle>1 in=mal pres5tation ( bi(e$back4 #cjd ,v4 ,,relaxation ,,tra9+ 7,,*apt] #ae7 ,b5son1 ,h]b]t4 ,! ,relaxation ,response4 ,new ,york3 ,morr[1 #aige4 ,jacobson1 ,e4 ,progressive ,relaxation4 ,*icago3 ,univ]sity ( ,*icago ,press1 #aicj4 ,"o ( ! fir/ /udies to exam9e sy/ematic muscle relaxation4 ,w4 ,,hypnosis 7,,*apt] #ae7 ,erickson1 ,milton1 ,erne/ ,l4 ,rossi1 & ,%eila ,i4 ,rossi4 ,hypnotic ,realities3 ,! ,induction ( ,cl9ical ,hypnosis & ,=ms ( ,indirect ,sugge/ion4 ,new ,york3 ,irv+ton ,publi%]s1 #aigf4 ,wallace1 ,b5jam94 ,appli$ ,hypnosis3 ,an ,ov]view4 ,*icago3 ,nelson-,hall1 #aigi4 ,a g5]al description ( hypnosis4 ,wolb]g1 ,lewis ,r4 ,hypnosis3 ,is ,x = ,y8 ,new ,york3 ,h>c\rt ,brace ,jovanovi*1 #aigb4 ,a good1 g5]al description ( hypnosis & its use 9 ! context ( psy*o!rapy4 ,x4 ,,m$itation 7,,*apt] #ae7 ,c>r+ton1 ,patricia4 ,fre$om 9 ,m$itation4 ,g>d5 ,city1 ,,ny3 ,an*or ,press1 #aigg4 ,by a cl9ical psy*ologi/ :o uses m$itation ) h] pati5ts1 a practical & compreh5sive discussion ( m$itation & its connection ) ! human problems t br+ p to psy*o!rapy4 ,glass]1 ,william4 ,positive ,addiction4 ,new ,york3 ,h>p] & ,r[1 #aigf4 ,see ,*apt] #f1 ,m$itation4 ,le,shan1 ,lawr5ce4 ,h[ to ,m$itate3 ,a ,guide to ,self-,discov]y4 ,bo/on3 ,little1 ,br[n ,co41 #aigd4 ,an intellig5t & mode/ practical approa* to m$itation4 ,y4 ,,drug ,,!rapy 7,,*apt] #af7 ,leavitt1 ,fr$4 ,drugs & ,behavior4 ,new ,york3 ,wiley1 #aihb4 ,physician's ,desk ,ref]5ce to ,ph>maceutical ,specialties & ,biologicals4 ,new ,j]sey3 ,m$ical ,economics1 ,inc4 ,publi%$ annually ) qu>t]ly supplem5ts4 ,gives detail$ in=mation ab\t drugs1 side effects1 pot5tial risks1 etc4 ,swong]1 ,alv9 ,k41 & ,l>ry ,l4 ,con/ant9e4 ,drugs & ,!rapy3 ,a ,psy*o!rapi/'s ,h&book ( ,psy*otropic ,drugs4 ,bo/on3 ,little1 ,br[n ,co41 #aigf4 #cje ,z4 ,,diet ,,!rapy 7,,*apt] #af7 ,fr$]icks1 ,c>lton4 ,psy*o-,nutrition4 ,new ,york3 ,grosset ,dunlap1 #aigf4 ,watson1 ,george4 ,nutrition & ,y\r ,m9d3 ,! ,psy*o*emical ,response4 ,new ,york3 ,h>p] & ,r[1 #aigb4 ,,on ,,legal ,,issues ,,9 ,,psy*o!rapy 7,,*apt] #ai7 ,coh51 ,ronald ,jay4 ,legal ,guidebook 9 ,m5tal ,heal?4 ,new ,york3 ,free ,press1 #aihb4 ,gu!il1 ,?omas ,g41 & ,paul ,s4 ,appelbaum4 ,cl9ical ,h&book ( ,psy*iatry & ! ,law4 ,new ,york3 ,mc,graw-,hill1 #aihb4 ,h(l+1 ,*>les ,k41 ed4 ,law & ,e?ics 9 ! ,practice ( ,psy*iatry4 ,new ,york3 ,brunn]_/,mazel1 #aiha4 ,,on ,,! ,,effectiv5ess ,,( ,,psy*o!rapy 7,,*apt] #bj7 ,eys5ck1 ,hans ,j4 ,! ,battle ov] ,!rapeutic ,effectiv5ess1 9 ,jusuf ,h>iman1 ed41 ,does ,psy*o!rapy ,really ,help ,p8 ,spr+field1 ,,il3 ,*>les ,c4 ,?omas1 #aihd1 pp4 #eb-fa4 ------4 ,! ,effects ( ,psy*o!rapy4 ,new ,york3 ,int]-,sci5ce ,press1 #aiff4 ,h>iman1 ,jusuf1 ed4 ,does ,psy*o!rapy ,really ,help ,p8 ,spr+field1 ,,il3 ,*>les ,c4 ,?omas1 #aihd4 ,a collection ( evaluative articles ab\t psy*o!rapy4 ------4 ,! ,!rapeutic ,efficacy ( ! ,major ,psy*o!rapeutic ,te*niques4 ,spr+field1 ,,il3 ,*>les ,c4 ,?omas1 #aihb4 ,a collection ( pap]s ab\t ! !rapeutic effectiv5ess ( a v>iety ( approa*es to psy*o!rapy4 ,ra*man1 ,s41 & ,g4 ,t4 ,wilson4 ,! ,effects ( ,psy*ological ,!rapy4 ,ox=d3 ,p]gamon ,press1 #aihj4 ,wolff1 ,w]n]1 ed4 ,success 9 ,psy*o!rapy4 ,new ,york3 ,grune ,/ratton1 #aieb4 #cjg ,,index ,,ndx ,adjunctive !rapies1 #hi ,adju/m5t problems1 #fi1 #gd ,adl]1 ,alfr$1 #aeh ,adl]ian !rapy1 #ib1 #aeg-fa ,a]obic ex]cise1 #bje-h ,affective disord]s1 #fi1 #gc-gd drug !rapy &1 #bcd ,ag5cies1 #bhi-ig public1 #ee ,ag+1 problems (1 #fi1 #gf ,alcoholics ,anonym\s1 #ahh ,alcoholism1 #gg1 #ajh ,alzheim]'s disease1 #gg ,anemia1 #ajg ,ane/hesia1 hypnosis &1 #bba ,antianxiety drugs1 #bbh1 #bca ,anticipatory anxiety1 #aeb ,antidepressants1 #bbi1 #bcb side effects (1 #bcc ,antiepileptic drugs1 #bbi ,antip>k9sonian drugs1 #bbi ,antipsy*otic drugs1 #bbh1 #bce ,anxiety anticipatory1 #aeb c\nt]-condition+ &1 #agf drug !rapy &1 #bbh1 #bcj runn+ &1 #baj ,anxiety attacks1 #gb ,articulat5ess1 #hc ,associations1 pr(essional1 #bdg-dh1 #bic1 #bif ,behavior modification1 #id1 #age1 #agg1 #ahj family !rapy &1 #bja ,behavioral !rapy1 #agc-hc case hi/ory (1 #ahj-hb ,belief sy/ems1 #ada ,b]ne1 ,eric1 #acb ,bio5]getics1 #eb1 #ic1 #afb ,bi(e$back1 #ej1 #if1 #agh1 #baa-ad h[ to f9d1 #bdh ,blood sug> disord]s1 #ajc-e ,bo>d eligibility1 #df ,bra9 dysfunction1 organic1 #gg ,bra9 tumors1 #ajf #cjh ,brea? c\nt+1 #bbd ,bubble1 m$itation (1 #bbe ,byrd1 ,ri*>d1 #i-aa ,caffe9e1 #ajh1 #bbi ,canc]1 pancreatic1 #ajf ,*ildhood disord]s1 #fh1 #gj psy*oanalysis &1 #aag ,*ildr51 con=mity &1 #ac ,*oice po9t1 #afh ,cli5t-c5t]$ !rapy1 #ij1 #abd-bf ,cl9ical psy*ology1 #db1 #bdf ,cognitive !rapy1 #ie1 #aci-de behavior *ange &1 #age1 #agh-gi1 #ahj ,commitm5t1 #hj ,compulsions1 #gb ,conditional love1 #abd ,confid5tiality1 #beg-ff ,con=mity1 #ac ,congru5ce1 #ce ,contemplative m$itation1 #bbe ,cont5t analysis1 #aib ,cop+ /rategy1 #bag ,co/ ( !rapy1 #bej ,c\nsel+1 academic1 #ef ,c\nsel+ psy*ology1 #dc ,c\nselors social "w1 #bi1 #dj-db1 #bdf-dh religi\s1 #dh-ej ,c\nt]-condition+ !rapy1 #id1 #agd-gg1 #ahb ,c\nt]transf]5ce1 #aai ,c\nty c\nsel+ ag5cies1 #ee ,crisis int]v5tion1 #fi1 #gf ,decision mak+1 #agi ,def5se me*anisms1 #cc ,delusions1 #gf ,demoralization1 #bga ,depression1 #gc-gd drug !rapy &1 #bbi1 #bca-cd electroconvulsive !rapy &1 #bcc logo!rapy &1 #aeb runn+ &1 #bjh ,d]eflection1 #aeb ,des5sitization1 #agg1 #baf ,diabetes1 #ajc ,diagnosis1 self4 ,see ,self-diagnosis ,direct decision !rapy1 #ic1 #afg-gb case hi/ory (1 #afh h[ to f9d1 #bdh ,di/raction te*niques1 #agh ,drug addiction1 #gg1 #ajh ,drug !rapy1 #bbg-cf appropriat5ess (1 #bce drugs us$ 91 #bbh-cj ,see also ,m$ication ,dynamic psy*o!rapy1 #aae ,dysphoria1 #bjf ,ego1 developm5t (1 #ac ,ego /ates1 #acb ,electroconvulsive !rapy1 #bcc ,ellis1 ,alb]t1 #adj ,emotional flood+ !rapies1 #afa-fg h[ to f9d1 #bdh ,enc\nt] gr\ps1 #ahg ,endog5\s depression1 #bbi ,epilepsy1 #aje drug !rapy &1 #bbi ,erickson1 ,milton ,h41 #bai ,esal5 ,in/itute1 #ahh e/1 #ahh ,ex]cise1 #hb ,ex]cise !rapy1 #ec1 #if1 #bjd-aa h[ to f9d1 #bdi ,exi/5tial-humani/ic !rapy1 #ib1 #ade-di h[ to f9d1 #bdh ,exog5\s depression1 #bbi ,extrov]sion1 #hb ,family problems1 #ge ,family !rapy1 #ie1 #aid-bjc ,fe$back loops1 #aja #cji ,frankl1 ,viktor1 #aea ,free association1 #aae ,free *oice1 #bb ,fre$om1 psy*ological1 #cf ,freud1 ,sigmund1 #aac-ad ,fru/ration1 #ha ,ge/alt !rapy1 #ij1 #abg-cb ,glass]1 ,william1 #aed ,goals family !rapy &1 #aif p]sonal1 #ba1 #fg1 #gj sett+ (1 #fb ,gre5wald1 ,h>old1 #afg ,gr\p process1 #aib ,gr\p sett+s1 reaction to1 #hd ,gr\p !rapy1 #ie1 #ahd-ic confid5tiality &1 #bfa risks (1 #aia ,gr[? disord]s1 #abh ,habits1 #cc *anges 91 #cd ,haley1 ,jay1 #aig ,halluc9ations1 #gf ,halluc9og5s1 #bcj ,ha?a yoga1 #ec ,haw?orne effect1 #bgf ,head injuries1 #ajf ,heada*e drugs1 #bcj ,heal? insurance1 confid5tiality &1 #bfb ,he>t conditions1 #ajg ,helpfulness ( !rapy1 #bfg-ha ,holism1 #eb ,home visits by !rapi/1 #bja ,hospitalization1 #ef1 #beb-ef ,human pot5tial gr\ps1 #ahg ,humani/ic !rapies1 #abc-di ,hunt+ton's *orea1 #gg ,hyp]?yroidism1 #ajb ,hypnosis1 #ea1 #ig1 #bag-bc h[ to f9d1 #bdi ,hypnotic drugs1 #bbi ,hypoglycemia1 #ajd ,hypo?yroidism1 #ajc ,iatrog5ic di/urbances1 #bfh ,illness1 solitude &1 #ac ,imag9ation1 #hd ,implosive !rapy1 #ic1 #afe-fg ,indirect induction hypnosis1 #bai ,infants1 ne$ = contact1 #aa ,infecti\s diseases1 #ajh ,inf]iority1 ,adl]ian !rapy &1 #aeh ,inhibition1 #hb reciprocal1 #agd ,initial consultation1 #bea ,initiative1 #ha ,injuries1 head1 #ajf ,inpati5t !rapy1 #ef1 #beb-ef ,insurance1 confid5tiality &1 #bfb ,int5sive feel+ !rapy1 #afd ,introv]sion1 #hb ,involunt>y behavior1 #fi1 #gf ,janov1 ,ar?ur1 #afc ,jogg+1 !rapeutic1 #bje-g ,ko/rubala1 ,?addeus1 #bje ,law1 confid5tiality &1 #bfj ,life decisions1 #agj ,li?ium !rapy1 #bbi1 #bcc ,logo!rapy1 #ib1 #aej-ed h[ to f9d1 #bdh ,long-di/ance runn+1 #bji ,love1 #cf conditional1 #abd ,l[51 ,alex&]1 #afb ,mania1 #gd ,manic depression1 #gd li?ium !rapy &1 #bbi ,,mao inhibitors1 #bcb ,m>ital problems1 #ge ,m>riage !rapy1 #ie1 #aid-bjc case hi/ory (1 #aii ,m$ication1 #de1 #ih reaction to1 #ajh ,see also ,drug !rapy #caj ,m$itation1 #ea1 #ig1 #bbc-bf h[ to f9d1 #bdi ,m5opause1 #ajg ,metabolic diseases1 #ajb-e ,migra9e drugs1 #bcj ,mitral incompet5ce1 #ajg ,model1 psy*ological1 #be-bg ,mood di/urbances1 #fi1 #gc-gd ,multifamily !rapy1 #bja ,multiple scl]osis1 #ajf ,ne$ = !rapy1 #bdb ,negative practice1 #afj ,negative traits1 #cf ,n]v\s breakd[n1 #cc ,n]v\s sy/em disord]s1 #aje-f ,neuralgia drugs1 #bcj ,neuroleptic drugs1 #bbh ,neuroses1 #fh1 #ga nog5ic1 #gc1 #aec ,nicot9e1 #bbi ,night t]ror1 #aag ,,nimh m5tal heal? survey1 #ah ,nonv]bal communication1 #aib ,nog5ic neuroses1 #gc logo!rapy &1 #aec ,nurs+1 psy*iatric1 #bed ,nutrition1 #ih1 #bcf-cg ,organic disord]s1 #fi1 #gg ,organizations1 #bhi-ig ,or?omolecul> psy*iatry1 #bcf ,out]-direct$ness1 gr\p !rapy &1 #ahd ,pa9 bi(e$back &1 #bac emotional1 #ae1 #bg hypnosis &1 #bba ,pancreatic canc]1 #ajf ,panic attacks1 #gb ,p>adoxical int5tion1 #aec1 #afj family !rapy &1 #bja ,p>k9sonism1 #gg1 #aje drug !rapy &1 #bbi ,p>oxysmal ta*yc>dia1 #ajg ,pati5ce1 #ha ,p]fectionism1 #hb ,p]ls1 ,fr$]ick1 #abh ,p]sonality developm5t (1 #cb model (1 #be-bg !rapy selection &1 #gh-he ,p]sonality traits1 #gi-he disord]s (1 #fh1 #ga ,phobias1 #gb1 #afe ,physical illness1 #ii-aji ,placebos1 #bfh1 #bgb ,po/-!rapy life1 #bhb-h ,po/-traumatic /ress disord]s1 #gb ,premature ego developm5t1 #ac ,primal !rapy1 #ic1 #afc-fe ,privacy1 #beg-ff ,private practice1 #ed ,problem avoidance1 #bhc ,problem solv+1 #agi ,pr(essional associations1 #bdg-dh1 #bic1 #bif ,pseudo-self-suffici5cy1 #ac ,psy*$elic drugs1 #bcj ,psy*iatri/s1 #bi1 #dd-dg h[ to f9d1 #bde ,psy*oanalysis1 #de1 #ij1 #aac-bb brief1 #abj case hi/ories 91 #aaf-bj *ildr5 &1 #aag ,psy*ological disord]s age &1 #ai ,,nimh /udy (1 #ah social views t[>ds1 #ad wom5's response to1 #ai ,psy*ological te/s1 #dc ,psy*ologi/s1 #bi1 #db-dd h[ to f9d1 #bdf ,psy*ometri/s1 #dc ,psy*onutrition1 #bcf ,psy*oses1 #fi1 #gf drug !rapy &1 #bbh1 #bcd ,psy*osomatic disord]s1 #gc ,psy*o!rapy4 ,see ,!rapy li/+s ,psy*otropic drugs1 #bbh-cj ,see also ,drug !rapy #caa ,rational-emotive !rapy1 #ia1 #aci-de case hi/ory (1 #adb ,reality !rapy1 #ib1 #aed-eg ,reciprocal inhibition1 #agd ,recov]y1 ,inc41 #ahh ,ref]rals to !rapi/1 #bdd ,reflectiv5ess1 #hc ,rei*1 ,wilhelm1 #afb ,relapses1 #bhc ,relaxation tra9+1 #ej1 #if1 #agf1 #bae-ag h[ to f9d1 #bdi ,religi\s c\nselors1 #dh-ej ,responsibility1 #ab ,rew>d & puni%m5t1 #agg ,rigidity1 #ha ,rog]s1 ,c>l1 #abd ,role-play+1 #abh ,runn+1 !rapeutic1 #bje-g ,s*izophr5ia1 runn+ &1 #baj ,s*ools1 c\nsel+ s]vices 91 #ef ,secrecy1 cli5t's ne$ =1 #bfd ,s$atives1 #bbi ,self-control1 #ab ,self-diagnosis1 #ei-ih ob/acles to1 #fa self-evaluation &1 #fb-fd ,see also ,!rapy selection ,self-discipl9e1 #hj ,self-e/eem1 #cf cli5t-c5t]$ !rapy &1 #abf ,self-evaluation1 #fb-fd ,self-help gr\ps1 #ahh1 #bhi-ib1 #bid-if ,self-suffici5cy1 #ab ,s5esc5ce1 #gg ,sexual disord]s1 #gc m>riage !rapy &1 #bjc ,%ort-t]m enc\nt] gr\ps1 #ahg ,%ortcom+s ( !rapy1 #bgd ,sk9n]1 ,b4 ,f41 #age ,smok+1 #gg1 #aji ,social "w c\nselors1 #bi1 #dj-db h[ to f9d1 #bdf-dh ,spontane\s remission1 #bfh1 #bgc ,/ampfl1 ,?omas1 #afe ,/ate c\nsel+ ag5cies1 #ee ,/imulants1 #bbi ,/ress1 #ce po/-traumatic1 #gb relaxation tra9+ &1 #bae ,/ructural analysis1 #acd ,sub/ance abuse1 #gg ,suicide1 #ab ,symptoms1 behavioral !rapy &1 #agd ,szasz1 ,?omas1 #bgj ,ta*yc>dia1 #ajg ,te/s1 psy*ological1 #dc ,t-gr\ps1 #ahg ,!rapeutic goals1 #ag1 #bc-be ,!rapeutic results1 #ce-cg ,!rapi/s1 #bda-ea categories (1 #bi co/ (1 #bej ne$ =1 #bdb private vs4 public1 #ed qualities (1 #cg-ch ref]ral to1 #bdd specialization by1 #bdc ,see also "u specific !rapy ,!rapy effectiv5ess1 #bfg-ha ,!rapy selection disord]s &1 #fh-gg p]sonal goals &1 #fg1 #gj p]sonality &1 #gh-he /eps 91 #fe-eg ,!rapy types1 #hf-ih4 ,see also specific "n ( !rapy ,?\ght /opp+1 #agi ,?yroid disord]s1 #ajb ,tol]ance1 #ha ,trance1 hypnotic1 #bah ,tranquiliz]s1 #bbh ,transactional analysis1 #ia1 #acb-ci case hi/ory (1 #acf #cab ,transf]5ce1 #aai ,trauma1 /ress foll[+1 #gb ,tumors1 bra91 #ajf ,values1 p]sonal1 #hd ,vitam9s1 #bcg ,wolb]g1 ,lewis ,r41 #bbb ,wolpe1 ,joseph1 #agd ,yoga1 #ec ,,endx #cac ,,ab\t ,,! ,,au?or ,/ev5 ,james ,b>tlett 0 born 9 ,mexico ,city & educat$ 9 ,mexico1 ! ,unit$ ,/ates1 & ,france4 ,he did 8 und]graduate "w at ! ,univ]sity ( ,santa ,cl>a & at ,raymond ,college1 an ,ox=d-/yle honors college ( ! ,univ]sity ( ! ,pacific4 ,he receiv$ 8 ma/]'s degree f ! ,univ]sity ( ,cali=nia1 ,santa ,b>b>a2 8 doctorate f ! ,univ]sit de ,p>is1 :]e 8 rese>* 0 direct$ by ,paul ,ricoeur2 & has done po/-doctoral /udy 9 psy*ology & psy*o!rapy4 ,he has be5 ! recipi5t ( _m honors1 aw>ds1 grants1 s*ol>%ips1 & fell[%ips4 ,8 rese>* has be5 support$ "u contract or grant by ! ,alliance ,franaise1 ! ,am]ican ,association = ! ,advancem5t ( ,sci5ce1 ! ,c5t] = ! ,/udy ( ,democratic ,in/itutions1 ! ,lilly ,end[m5t1 ! ,max-,planck-,gesells*aft1 ! ,national ,sci5ce ,f\ndation1 ! ,r& ,corporation1 & o!rs4 ,b>tlett br+s to ! pres5t "w an unusual backgr\nd consi/+ ( tra9+ 9 cl9ical psy*ology1 pa?ology1 & epi/emology4 ,he is ! au?or & editor ( fifte5 books & monographs1 & m ?an a hundr$ pap]s & rese>* /udies 9 ! fields ( psy*ology1 epi/emology1 & philosophy ( sci5ce4 ,he has taught at ,sa9t ,l\is ,univ]sity & ! ,univ]sity ( ,florida1 & has held rese>* positions at ! ,max-,planck-,in/itute 9 ,/>nb]g1 ,g]many & at ! ,c5t] = ! ,/udy ( ,democratic ,in/itutions 9 ,santa ,b>b>a4 ,he is curr5tly ,visit+ ,s*ol> 9 ,psy*ology at ,willamette ,univ]sity & ,s5ior ,rese>* ,pr(essor at ,oregon ,/ate ,univ]sity4 ,willamette ,univ]sity ho/s a website t provides in=mation ab\t ! au?or & 8 rese>*1 & makes available a l>ge numb] ( 8 publications 9 free d[nloadable =m3 http3_/_/www4willamette4edu_/sb>tlet