pel4e_ch14

14.1 Treating Psychological Disorders

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LOQ LearningObjectiveQuestion

14-1 How do psychotherapy and the biomedical therapies differ?

DOROTHEA DIX “I . . . call your attention to the state of the Insane Persons confined within this Commonwealth, in cages.”

The long history of efforts to treat psychological disorders has included a strange mix of methods, harsh and gentle. Would-be healers have cut holes in people’s heads and restrained, bled, or “beat the devil” out of them. But they also have given warm baths and massages and placed people in sunny and peaceful settings. They have given them drugs. And they have talked with them about childhood experiences, current feelings, and maladaptive thoughts and behaviors.

THE HISTORY OF TREATMENT Visitors to eighteenth-century mental hospitals paid to gawk at patients, as though they were viewing zoo animals. William Hogarth’s (1697–1764) painting captured one of these visits to London’s St. Mary of Bethlehem hospital (commonly called Bedlam).

The transition to gentler methods began when reformers such as Philippe Pinel (1745–1826), Dorothea Dix (1802–1887), and others pushed for more humane treatments and for constructing mental hospitals. Since the 1950s, drug therapies and community-based treatment programs have replaced most of those hospitals.

Modern Western therapies fall into two main categories.

psychotherapy treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth.

In psychotherapy, a trained therapist uses psychological techniques to assist someone seeking to overcome difficulties or achieve personal growth. The therapist may explore a client’s early relationships, encourage the client to adopt new ways of thinking, or coach the client in replacing old behaviors with new ones.

biomedical therapy prescribed medications or procedures that act directly on the person’s physiology.
Biomedical therapy offers medications or other biological treatments. For example, a person with severe depression may receive antidepressants, electroconvulsive shock therapy (ECT), or deep brain stimulation.

The care provider’s training and expertise, as well as the disorder itself, influence the choice of treatment. Psychotherapy and medication are often combined. Kay Redfield Jamison received psychotherapy in her meetings with her psychiatrist, and she took medications to control her wild mood swings.

Let’s look first at the psychotherapy options for those treated with “talk therapies.”