Cognitive behavioral therapy is a combination of traditional behavioral therapy and cognitive therapy. They are combined into a treatment that is focused on symptom removal. The effectiveness of the treatment can clearly be judged based on its results. The more it is used, the more it has become recommended. It is now used as the number one treatment technique for post traumatic stress disorder, obsessive compulsive disorder, depression and bulimia.

Cognitive behavioral therapy first began to be used between 1960 and 1970. It was a gradual process of merging behavioral therapy techniques and cognitive therapy techniques. Behavioral therapy had been around since the 1920’s, but cognitive therapy was not introduced until the 1960’s. Almost immediately the benefits of combining it with behavioral therapy techniques were realized. Ivan Pavlov, with his dogs who salivated at the ringing of the dinner bell, was among the most famous of the behavioral research pioneers. Other leaders in the field included John Watson and Clark Hull.

Instead of focusing on analyzing the problem like Freud and the psychoanalysts, cognitive behavioral therapy focused on eliminating the symptoms. The idea being that if you eliminate the symptoms, you have eliminated the problem. This more direct approach was seen as more effective at getting to the problem at hand and helping patients to make progress more quickly.

As a more radical aggressive treatment, behavioral techniques dealt better with more radical problems. The more obvious and clear cut the symptoms were, the easier it was to target them and devise treatments to eliminate them. Behavioral therapy was not as successful initially with more ambiguous problems such as depression. This realm was better served with cognitive therapy techniques.

In many academic settings, the two therapy techniques were used side by side to compare and contrast the results. It was not long before the advantages of combining the two techniques became clear as a way of taking advantage of the strengths of each. David Barlow’s work on panic disorder treatments provided the first concrete example of the success of the combined strategies.

Cognitive behavioral therapy is difficult to define in a succinct definition because it covers such a broad range of topics and techniques. It is really an umbrella definition for individual treatments that are specifically tailored to the problems of a specific patient. So the problem dictates the specifics of the treatment, but there are some common themes and techniques. These include having the patient keep a diary of important events and record the feelings and behaviors they had in association with each event. This tool is then used as a basis to analyze and test the patient’s ability to evaluate the situation and develop an appropriate emotional response. Negative emotions and behaviors are identified as well as the evaluations and beliefs that lead to them. An effort is then made to counter these beliefs and evaluations to show that the resulting behaviors are wrong. Negative behaviors are eliminated and the patient is taught a better way to view and react to the situation.

Part of the therapy also includes teaching the patient ways to distract themselves or change their focus from something that is upsetting or a situation that is generating negative behavior. They learn to focus on something else instead of the negative stimulus, thus eliminating the negative behavior that it would lead to. The problem is essentially nipped in the bud. For serious psychological disorders like bipolar disorder or schizophrenia, mood stabilizing medications are often prescribed to use in conjunction with these techniques. The medications give the patient enough of a calming effect to give them the opportunity to examine the situation and make the healthy choice whereas before they could not even pause for rational thought.

Cognitive behavioral therapy has been proven effective for a variety of problems, but it is still a process, not a miracle cure. It takes time to teach patients to understand situations and identify the triggers of their negative behaviors. Once this step is mastered, it still takes a lot of effort to overcome their first instincts and instead stop and make the right choices. First they learn what they should do, and then they must practice until they can do it.

Bethany Jordan is an Information Technology professional and aspiring writer who was clinically diagnosed with SAD (Social Anxiety Disorder) in 2007.

She maintains a website dedicated to sharing information on natural antidepressants, herbal remedies for anxiety and depression, and anxiety disorders in general. Everyone is welcome and invited to visit http://www.naturalantidepressants.info …

Article Source: http://EzineArticles.com/?expert=Bethany_Jordin

Cognitive behavioral therapy is an approach used by psychotherapists to influence a patient’s behaviors and emotions. The key to the approach is in its procedure which must be systematic. It has been used successfully to treat a variety of disorders including eating disorders, substance abuse, anxiety and personality disorders. It can be used in individual or group therapy sessions and the approach can also be geared towards self help therapy.

Cognitive behavioral therapy is a combination of traditional behavioral therapy and cognitive therapy. They are combined into a treatment that is focused on symptom removal. The effectiveness of the treatment can clearly be judged based on its results. The more it is used, the more it has become recommended. It is now used as the number one treatment technique for post traumatic stress disorder, obsessive compulsive disorder, depression and bulimia.

Cognitive behavioral therapy first began to be used between 1960 and 1970. It was a gradual process of merging behavioral therapy techniques and cognitive therapy techniques. Behavioral therapy had been around since the 1920’s, but cognitive therapy was not introduced until the 1960’s. Almost immediately the benefits of combining it with behavioral therapy techniques were realized. Ivan Pavlov, with his dogs who salivated at the ringing of the dinner bell, was among the most famous of the behavioral research pioneers. Other leaders in the field included John Watson and Clark Hull.

Instead of focusing on analyzing the problem like Freud and the psychoanalysts, cognitive behavioral therapy focused on eliminating the symptoms. The idea being that if you eliminate the symptoms, you have eliminated the problem. This more direct approach was seen as more effective at getting to the problem at hand and helping patients to make progress more quickly.

As a more radical aggressive treatment, behavioral techniques dealt better with more radical problems. The more obvious and clear cut the symptoms were, the easier it was to target them and devise treatments to eliminate them. Behavioral therapy was not as successful initially with more ambiguous problems such as depression. This realm was better served with cognitive therapy techniques.

In many academic settings, the two therapy techniques were used side by side to compare and contrast the results. It was not long before the advantages of combining the two techniques became clear as a way of taking advantage of the strengths of each. David Barlow’s work on panic disorder treatments provided the first concrete example of the success of the combined strategies.

Cognitive behavioral therapy is difficult to define in a succinct definition because it covers such a broad range of topics and techniques. It is really an umbrella definition for individual treatments that are specifically tailored to the problems of a specific patient. So the problem dictates the specifics of the treatment, but there are some common themes and techniques. These include having the patient keep a diary of important events and record the feelings and behaviors they had in association with each event. This tool is then used as a basis to analyze and test the patient’s ability to evaluate the situation and develop an appropriate emotional response. Negative emotions and behaviors are identified as well as the evaluations and beliefs that lead to them. An effort is then made to counter these beliefs and evaluations to show that the resulting behaviors are wrong. Negative behaviors are eliminated and the patient is taught a better way to view and react to the situation.

Part of the therapy also includes teaching the patient ways to distract themselves or change their focus from something that is upsetting or a situation that is generating negative behavior. They learn to focus on something else instead of the negative stimulus, thus eliminating the negative behavior that it would lead to. The problem is essentially nipped in the bud. For serious psychological disorders like bipolar disorder or schizophrenia, mood stabilizing medications are often prescribed to use in conjunction with these techniques. The medications give the patient enough of a calming effect to give them the opportunity to examine the situation and make the healthy choice whereas before they could not even pause for rational thought.

Cognitive behavioral therapy has been proven effective for a variety of problems, but it is still a process, not a miracle cure. It takes time to teach patients to understand situations and identify the triggers of their negative behaviors. Once this step is mastered, it still takes a lot of effort to overcome their first instincts and instead stop and make the right choices. First they learn what they should do, and then they must practice until they can do it.

Bethany Jordan is an Information Technology professional and aspiring writer who was clinically diagnosed with SAD (Social Anxiety Disorder) in 2007.

She maintains a website dedicated to sharing information on natural antidepressants, herbal remedies for anxiety and depression, and anxiety disorders in general. Everyone is welcome and invited to visit http://www.naturalantidepressants.info …

Article Source: http://EzineArticles.com/?expert=Bethany_Jordin

Adult pathological narcissism is no more “curable” than the entirety of one’s personality is disposable. The patient is a narcissist. Narcissism is more akin to the colour of one’s skin rather than to one’s choice of subjects at the university.

Moreover, the Narcissistic Personality Disorder (NPD) is frequently diagnosed with other, even more intractable personality disorders, mental illnesses, and substance abuse.

Cognitive-Behavioral Therapies (CBTs)

The CBTs believe that insight – even if merely verbal and intellectual – is sufficient to induce an emotional outcome. If properly manipulated, verbal cues, insights, analyses of standard sentences we keep saying to ourselves (”I am ugly”, “I am afraid no one would like to be with me”), inner dialogues and narratives, and repeated behavioural patterns (learned behaviours) coupled with positive (and, rarely, negative) reinforcements – are sufficient to induce a cumulative emotional effect tantamount to healing.

Psychodynamic theories do not believe that cognition can influence emotion. They believe that much deeper strata have to be accessed and studied by both patient and therapist. The very exposure of these strata is considered sufficient to induce a dynamic of healing. The therapist’s role is either to interpret the material revealed to the patient (psychoanalysis) by allowing the patient to transfer past experience and superimpose it on the therapist – or to actively engage in providing a safe emotional and holding environment conducive to changes in the patient.

The sad fact is that no known therapy is effective with narcissism ITSELF – though a few therapies are reasonably successful as far as coping with some of its effects goes (behavioural modification).

Dynamic Psychotherapy

Or Psychodynamic Therapy, Psychoanalytic Psychotherapy

As opposed to common opinion it is NOT psychoanalysis. It is an intensive psychotherapy BASED on psychoanalytic theory WITHOUT the (very important) element of free association. This is not to say that free association is not used – only that it is not a pillar of the technique in dynamic therapies. Dynamic therapies are usually applied to patients not considered “suitable” for psychoanalysis (such as Personality Disorders, except the Avoidant PD).

Typically, different modes of interpretation are employed and other techniques borrowed from other treatments modalities. But the material interpreted is not necessarily the result of free association or dreams and the psychotherapist is a lot more active than the psychoanalyst.

These treatments are open-ended. At the commencement of the therapy the therapist (analyst) makes an agreement (a “pact”) with the analysand (patient or client). The pact says that the patient undertakes to explore his problems no matter how long it takes (and how expensive it becomes). This is supposed to make the therapeutic environment much more relaxed because the patient knows that the analyst is at his/her disposal no matter how many meetings would be required in order to broach painful subject matter.

Sometimes, these therapies are divided to expressive versus supportive, but I regard this division as misleading.

Expressive means uncovering (=making conscious) the patient’s conflicts and studying his/her defences and resistances. The analyst interprets the conflict in view of the new knowledge gained and guides the therapy towards a resolution of the conflict. The conflict, in other words, is “interpreted away” through insight and the change in the patient motivated by his/her insights.

The supportive therapies seek to strengthen the Ego. Their premise is that a strong Ego can cope better (and later on, alone) with external (situational) or internal (instincts, drives) pressures. Supportive therapies seek to increase the patient’s ability to REPRESS conflicts (rather than bring them to the surface of consciousness). As a painful conflict is suppressed – so are all manner of dysphorias and symptoms. This is somewhat reminiscent of behaviourism (the main aim is to change behaviour and to relieve symptoms). It usually makes no use of insight or interpretation (though there are exceptions).

Group Therapies

Narcissists are notoriously unsuitable for collaborative efforts of any kind, let alone group therapy. They immediately size up others as potential Sources of Narcissistic Supply – or potential competitors. They idealise the first (suppliers) and devalue the latter (competitors). This, obviously, is not very conducive to group therapy.

Moreover, the dynamic of the group is bound to reflect the interactions of its members. Narcissists are individualists. They regard coalitions with disdain and contempt. The need to resort to team work, to adhere to group rules, to succumb to a moderator, and to honour and respect the other members as equals – is perceived by them to be humiliating and degrading (a contemptible weakness). Thus, a group containing one or more narcissists is likely to fluctuate between short-term, very small size, coalitions (based on “superiority” and contempt) and outbreaks (acting outs) of rage and coercion.

Can Narcissism be Cured?

Adult narcissists can rarely be “cured”, though some scholars think otherwise. Still, the earlier the therapeutic intervention, the better the prognosis. A correct diagnosis and a proper mix of treatment modalities in early adolescence guarantees success without relapse in anywhere between one third and one half the cases. Additionally, ageing ameliorates or even vanquishes some antisocial behaviors.

In their seminal tome, “Personality Disorders in Modern Life” (New York, John Wiley & Sons, 2000), Theodore Millon and Roger Davis write (p. 308):

“Most narcissists strongly resist psychotherapy. For those who choose to remain in therapy, there are several pitfalls that are difficult to avoid … Interpretation and even general assessment are often difficult to accomplish…”

The third edition of the “Oxford Textbook of Psychiatry” (Oxford, Oxford University Press, reprinted 2000), cautions (p. 128):

“… (P)eople cannot change their natures, but can only change their situations. There has been some progress in finding ways of effecting small changes in disorders of personality, but management still consists largely of helping the person to find a way of life that conflicts less with his character … Whatever treatment is used, aims should be modest and considerable time should be allowed to achieve them.”

The fourth edition of the authoritative “Review of General Psychiatry” (London, Prentice-Hall International, 1995), says (p. 309):

“(People with personality disorders) … cause resentment and possibly even alienation and burnout in the healthcare professionals who treat them … (p. 318) Long-term psychoanalytic psychotherapy and psychoanalysis have been attempted with (narcissists), although their use has been controversial.”

The reason narcissism is under-reported and healing over-stated is that therapists are being fooled by smart narcissists. Most narcissists are expert manipulators and they learn how to deceive their therapists.

Here are some hard facts:

There are gradations and shades of narcissism. The difference between two narcissists can be great. The existence of grandiosity and empathy or lack thereof are not minor variations. They are serious predictors of future dynamics. The prognosis is much better if they do exist.

There are cases of spontaneous healing and of “short-term NPD” [see Gunderson's and Roningstam work, 1996].

The prognosis for a classical NPD case (grandiosity, lack of empathy and all) is decidedly not good as far as long-term, lasting, and complete healing. Moreover, narcissists are intensely disliked by therapists.

BUT…

Side effects, co-morbid disorders (such as Obsessive-Compulsive behaviors) and some aspects of NPD (the dysphorias, the paranoiac dimensions, the outcomes of the sense of entitlement, the pathological lying) can be modified (using talk therapy and, depending on the problem, medication). these are not short-term or complete solutions – but some of them do have long-term effects.

The DSM is a billing and administration oriented diagnostic tool. It is intended to “tidy” up the psychiatrist’s desk. The Personality Disorders are ill demarcated. The differential diagnoses are vaguely defined. There are some cultural biases and judgements [see the diagnostic criteria of the Schizotypal PD]. The result is sizeable confusion and multiple diagnoses (”co-morbidity”). NPD was introduced to the DSM in 1980 [DSM-III]. There isn’t enough research to substantiate any view or hypothesis about NPD. Future DSM editions may abolish it altogether within the framework of a cluster or a single “personality disorder” category. As it is, the difference between HPD, BPD, AsPD, and NPD is, to my mind, rather blurred. When we ask: “Can NPD be healed?” we need to realise that we don’t know for sure what is NPD and what constitutes long-term healing in the case of an NPD. There are those who seriously claim that NPD is a cultural disease with a societal determinant.

Narcissists in Therapy

In therapy, the general idea is to create the conditions for the True Self to resume its growth: safety, predictability, justice, love and acceptance – a mirroring and holding environment. Therapy is supposed to provide these conditions of nurturance and the guidance necessary to achieve these goals (through transference, cognitive re-labelling or other methods). The narcissist must learn that his past experiences are not laws of nature, that not all adults are abusive, that relationships can be nurturing and supportive.

Most therapists try to co-opt the narcissist’s inflated ego (False Self) and defences. They compliment the narcissist, challenging him to prove his omnipotence by overcoming his disorder. They appeal to his quest for perfection, brilliance, and eternal love – and his paranoid tendencies – in an attempt to get rid of counterproductive, self-defeating, and dysfunctional behaviour patterns.

By stroking the narcissist’s grandiosity, they hope to modify or counter cognitive deficits, thinking errors, and the narcissist’s victim-stance. They contract with the narcissist to alter his conduct. Some even go to the extent of medicalizing the disorder, attributing it to a hereditary or biochemical origin and thus “absolving” the narcissist from guilt and responsibility and freeing his mental resources to concentrate on the therapy.

Confronting the narcissist head on and engaging in power politics (”I am cleverer”, “My will should prevail”, and so on) is decidedly unhelpful and could lead to rage attacks and a deepening of the narcissist’s persecutory delusions, bred by his humiliation in the therapeutic setting.

Successes have been reported by applying 12-step techniques (as modified for patients suffering from the Antisocial Personality Disorder), and with treatment modalities as diverse as NLP (Neurolinguistic Programming), Schema Therapy, and EMDR (Eye Movement Desensitization).

But, whatever the type of talk therapy, the narcissist devalues the therapist. His internal dialogue is: “I know best, I know it all, the therapist is less intelligent than I, I can’t afford the top level therapists who are the only ones qualified to treat me (as my equals, needless to say), I am actually a therapist myself…”

A litany of self-delusion and fantastic grandiosity (really, defences and resistances): “He (my therapist) should be my colleague, in certain respects it is he who should accept my professional authority, why won’t he be my friend, after all I can use the lingo (psycho-babble) even better than he does? It’s us (him and me) against a hostile and ignorant world (follies-a-deux)…”

Then there is: “Just who does he think he is, asking me all these questions? What are his professional credentials? I am a success and he is a nobody therapist in a dingy office, he is trying to negate my uniqueness, he is an authority figure, I hate him, I will show him, I will humiliate him, prove him ignorant, have his licence revoked (transference). Actually, he is pitiable, a zero, a failure…”

And this is only in the first three sessions of the therapy. This abusive internal dialogue becomes more vituperative and pejorative as therapy progresses.

Narcissists generally are averse to receiving medication. Resorting to medicines is an implied admission that something is wrong. Narcissists are control freaks. Additionally, many of them believe that medication is the “great equaliser” – it will make them lose their uniqueness, superiority and so on. That is unless they can convincingly present the act of taking their medicines as “heroism”, a part of a daring enterprise of self-exploration, a distinguishing feature and so on.

They often claim that the medicine affects them differently than it does other people, or that they have discovered a new, exciting way of using it, or that they are part of someone’s (usually themselves) learning curve (”part of a new approach to dosage”, “part of a new cocktail which holds great promise”). Narcissists must dramatise their lives to feel worthy and special. Aut nihil aut unique – either be special or don’t be at all. Narcissists are drama queens.

Very much like in the physical world, change is brought about only through incredible powers of torsion and breakage. Only when the narcissist’s elasticity gives way, only when he is wounded by his own intransigence – only then is there hope.

It takes nothing less than a real crisis. Ennui is not enough.

About The Author

Sam Vaknin is the author of Malignant Self Love – Narcissism Revisited and After the Rain – How the West Lost the East. He is a columnist for Central Europe Review, PopMatters, and eBookWeb , a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory Bellaonline, and Suite101 .

Until recently, he served as the Economic Advisor to the Government of Macedonia.

Visit Sam’s Web site at http://samvak.tripod.com; palma@unet.com.mk

Article Source: http://EzineArticles.com/?expert=Sam_Vaknin

Mental health professionals and staff thrive across the globe. Psychiatric counselling has helped patients a great deal in coming out of depressions, rectifying personality disorders, correcting insomnia etc. Aids Phobia is common among a large number of people. Possessing little or lack of knowledge about HIV, and misinformed about Aids, people panic and suffer from mental and physical aspects. There are many such psychic disorders and phobias, schizophrenic cases, nervous disorders that require the expertise of a psychiatrist to deal with these.

Anorexia is a very common psychological disorder and more so in today’s young girls. Anorexia is a mental disorder where a person stops eating or eats less for fear of getting fat. Eventually such habit leads to a loss of appetite. The concept of hour glass figure is a growing trend among today’s young girls and it has had disastrous effects on the body and mind. Anorexia nervosa is one of the most common psychiatric disorders among young women. 1% of all teenage girls suffer from the condition, while for boys it is 0.1%. The disease has physical side effects like infertility among women.

Like Anorexia, other common mental disorders include hallucination, depression, headache, fatigue, anxiety, confusion, erratic behaviour, hearing voices, and weight loss.

Psychiatry deals with what’s inside the head. And what’s inside the head is a result of some chemical imbalance which did not happen one fine day. The way people think, their beliefs, their culture and the experience, situations in life and a lot of other things tend to shape up their psyche, their thought pattern which might at moments or for a long time be seriously challenged due to circumstances. A psychiatrist through mental counselling and dosage of medicine try to revive the balance in the mind. The function of psychiatric treatment is to open the closed mind of the patient. The closed mindedness is what harms the patient who then undergoes tremendous depression, leading to symptoms of regular psychological disorder.

Schizophrenia is another common serious psychotic disorder and a consistent challenge in the field of psychiatry from a long time. It is an abnormal perception of reality that affects all five senses- sight, touch, smell, hearing, and touch. Hallucinations, bizarre delusions, abnormality in speech and disorganized thinking pattern, multiple and split personality traits, paranoia are common behavioral patterns among schizophrenic patients. People with schizophrenia usually suffer from major depression and anxiety disorders. Substance abuse including hard drugs remains a common problem. Social problems, such as unemployment, poverty and homelessness, are common. The average life expectancy of people with schizophrenia is about 10 years less than those without. One major reason behind this is the high suicidal rate among schizophrenics. Although not hereditary, Schizophrenia tends to run in families.

Delusion is another very common psychological disorder. People can have various degrees of delusions. In such cases, the patient holds on to his own idea about something even if it is wrong. The person might become so disillusioned, that he would not budge from his viewpoint even if presented with the correct facts. A person might believe that some conspiracy is going on behind his back. This might happen in workplace or at home. This leads to unrest, abnormal behavior, and rash reactions if the degree of delusion becomes high. Sometimes the patient’s beliefs get out of proportion and he might think of himself as Napoleon or Hitler or anyone else. Such short and long term delusions are common case studies in psychiatry.

Visual and/or auditory hallucinations must have had happened to everyone but the difference between normal and abnormal lies in the frequency of such hallucinations. People see things that are not there, or hear a voice as if someone called them. For people suffering from hallucinations, it happens often. Drug abuse is one reason for hallucination, where the treatment of drug abuse is more important than dealing with hallucination. For those hallucinating to a great extent without the help of any psychotic substance, psychological counselling and mild steroids and prescribed medicines work wonders.

The Department of Psychiatry in Vydehi Hospital provides exemplary clinical care, consultation services and treatment, both to inpatients and outpatients, along with crisis and emergency services. The department is devoted to the optimal recovery of patients suffering from psychiatric problems. The department has state of the art equipments for various therapies namely Biofeedback Therapy Relaxation therapy, Multi Behaviour therapy, Brain Polariser Sex Therapy, Aversion Therapy, Electro-Sleep Therapy, Electro-convulsive therapy. A different department deals with psychological issues and cases. The psychiatric services empower individuals to change their lives in a positive manner.

About The Author

Article written by Ranadwip Saha , working for Vydehi Medical College Bangalore.Who use to write blogs and articles in web.