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Psychodynamic therapies

A link between behavioural and cognitive perspectives was suggested by Seligman (1975-1992), Seligman & Maier, (1967) found in their research using dogs who were restrained and unable to avoid electric shocks, appeared to become passive and resigned to the shocks. Later when free to move and avoid the shocks, the dogs made no attempt to do so. Seligman termed this as ‘learned helplessness’ this was criticised because it did not take into account that some depressed people blame themselves for their depression whilst others blamed the external world for their depression.

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A refined version of learned helplessness theory suggests the attributions and interpretations that people put on their experiences are reflected in the way people either blamed the external world or themselves for their depression, Abramson, et al. (1978). According to Abramson et al, people who look at failure as their fault with no way up so to speak are more likely to become depressed. The negative attribution to their plight reinforces their feelings of helplessness.

This attributional style derives from learned histories such as family and school. According to questionnaires that looked at the way people interpret adversities in their life, to some degree, were able to predict the future susceptibility to depression of those who took part, Kinderman & Bentall, (1997). However once a depressive episode ends the cognititions of helplessness ends also. Gotlib & Colby, (1995), suggest that an attitude of helplessness could be a symptom rather than a cause for depression, they found that there is no difference between people who where formerly depressed and people who have never been depressed, when it came to viewing negative events with a helpless resignation.

Overall the capacity of people to experience sadness & joy is probably related to the punishment reward system within the realm of reproductive success. Unipolar and bipolar disorders are the extremes of this system. There are a number of reasons to associate the capacity for sadness as an adaptive trait elicited by certain cues, specifically by a loss of reproductive resources, such as money, a mate, health or relatives. Loss in this context signals adaptive behaviour, where future losses are prevented.

Two aspects of sadness might increase fitness, on the one hand it may motivate us to cease activities that may be causing losses and on the other hand it may prevent the usual tendency of optimism and enable us to assess our lives more effectively. Studies have found that most of us tend to overestimate our abilities and effectiveness. This is normally adaptive; it enables us to succeed in social competition and keeps us pursuing important strategies and relationships even at times when there is no pay off. Psychology a new introduction, Richard Gross et al. (2000).

Similarly, a manic reaction may be triggered by the perception of a gain in reproductive resources or (resource holding power, RHP). Gilbert (1990), describes this as a gain in ‘social attention-holding potential, (SHAP). SHAP refers to the quality of attention others pay to a particular person. According to Gilbert, humans compete with each other to be attended to, and valued by those in the group. When a group bestows a lot of quality attention toward an individual that individual rises in status. Ignored individuals are banished to low status. Extreme rises or falls in status may lead to mania or depression respectively. Attachment theory, Groes et al, (2000), is a possible explanation of affective disorders. According to Stevens & Price (1996).

‘ The foundation of a warm, intimate and lasting relationship with a dependable attachment figure is the basis of human happiness and security’. Threats to this relationship can cause anxiety and loss of an attachment figure may result in depression. Depression as a pathological state is particularly likely to occur in people who, because of ineffective attachment in childhood, fail to develop a mature capacity to deal with loss. Studies show that people prone to depression recall a lack of parental affection Parker (1984). A problem with this theory is that it does not recognise the capacity of people to transcend childhood trauma.

The different theories relating to Unipolar and Bipolar disorders, excluding genetic and biochemical reasons for depression, point to the individuals ability in giving and accepting affection as part of the probabilities of whether or not the likelihood of a depressive episode will occur. These abilities are learned, or not learned in childhood. An optimistic or pessimistic attitude to life goes a long way in how the individual perceives and interprets the world around them.

Treatments for depression are becoming more effective as new drugs and therapies are discovered, the emphasis on cognitive therapies is encouraging in so far as it enables the person to better manage episodes of depressive disorders. Many forms of psychotherapy, including some short-term (10-20 week) therapies, can help depressed individuals. ‘Talking therapies help people gain insight into and resolve their problems through verbal exchange with the therapist, sometimes combined with homework assignments between sessions. Behavioural therapists help people learn how to obtain more satisfaction and rewards through their own actions and how to unlearn the behavioural patterns that contribute to or are part of their depression.

Two short term psychotherapies that research has shown helpful for some forms of depression are interpersonal and cognitive/behavioural therapies. Interpersonal therapists focus on the person’s disturbed personal relationships that both cause and exacerbate the depression. Cognitive/behavioural therapists help people change the negative styles of thinking and behaving often associated with depression. Psychodynamic therapies, which are sometimes used to treat depressed people, focus on resolving the persons conflicted feelings. These therapies are often reserved until the depressive symptoms are significantly improved.

In general, severe depressive illnesses, particularly those that are recurrent, will require medication and today there are new drugs with less side affects than those, which have been used in the past. Most doctors today use the SSRIs, (Selective Serotonin Reuptake inhibitors). Introduced about a decade ago, these SSRIs have proven to be safe and affective with fewer adverse side effects than earlier drugs such as the tricyclic anti-depressants. The four current SSRIs are Fluoxetine, sertraline, paroxetine and citalopram.

Electro-convulsive Therapy is one of the most successful but controversial treatments for major depressive disorder. This treatment has been portrayed in films as cruel, barbaric, inhumane and almost torture like in the way it has been used in the care of people with depression. However it still remains one of the most effective treatments for major depression. Simply it works by disrupting the long-term memory through he introduction of short bursts of electricity to the person’s brain, creating in effect a ‘seizure’ or resetting the brain to its factory setting.

In conclusion, the research for this essay suggests that there is a bright future for people who suffer this debilitating disorder. Innovation in humanistic therapies and the use of effective drugs are beginning to win the battle in helping people with this disorder. The world and the problems facing us all in the future are serious enough to make anyone depressed at some time or other. It will continue to effect people of all ages and cultures until such time as we can resolve some of the more destructive elements in our make up as human beings.

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