Chapter 2 – Summary

Several major paradigms, or points of view, are current in the study of psychopathology and therapy. The choice of paradigm has important consequences for the way in which abnormal behavior is defined, investigated, and treated.
The biological paradigm assumes that psychopathology is caused by an organic defect. Two biological factors relevant to psychopathology are genetics and neurochemistry. Biological therapies often use drug in effort to rectify the specific biological defects underlying disorders or to alleviate symptoms of disorders, often using drugs to do so.
The psychoanalytic, or psychodynamic, paradigm derives from the work of Sigmund Freud. It focuses on repression and other unconscious processes that are traceable to early childhood conflicts. Although present day ego analysts place greater emphasis on conscious ego functions, the psychoanalytic paradigm supports the searching of the unconscious and early life of the patient for the causes of abnormality. Therapeutic interventions based on psychoanalytic theory usually attempt to lift repressions so that the patient can examine the infantile and unfounded nature of his or her fears.
Humanistic and existential therapies are insight oriented, like psychoanalysis, and regard freedom to choose and personal responsibility as key human characteristics. Using empathy, Rogers's client-centered therapy entails complete acceptance of the client, restating of the client's thoughts and feelings, and sometimes offering a new perspectives on the client's problem. Existential therapies emphasize personal growth and a confronting of anxieties that are part of the choices we have to make in life. Perls' Gestalt therapy tries to help patients better understand and accept their needs, desires, and fears.
Behavioral, or learning, paradigms suggest that aberrant behavior has developed through classical conditioning, operant conditioning, or modeling. Investigators in this tradition share a commitment to examine carefully all situations affecting behavior as well as to define concepts carefully. Behavior therapists try to apply learning principles to the direct alteration of overt behavior, thought, and emotion. Less attention is paid to the historical causes of abnormal behavior than to the reward and punishment contingencies that encourage problematic response patterns.
Cognitive theorists have argued that certain schemas and irrational interpretations are major factors in abnormality. In both practice and theory, the cognitive paradigm blends with the behavioral in an approach to intervention that is referred to as cognitive-behavioral. Cognitive behavior therapists, such as Beck and Ellis, focus on altering patients’ negative schemas and interpretations.
Because each paradigm seems to have something to offer to our understanding of mental disorders, there has recently been a movement to develop more integrative paradigms. The diathesis-stress paradigm, which integrates several points of view, assumes that people are predisposed to react adversely to environmental stressors. The diathesis may be biological or psychological and may be caused by early-childhood experiences, genetically determined personality traits, or sociocultural influences.
Paralleling the current interest in integrative paradigms, most clinicians are eclectic in their approach to intervention employing techniques that are outside their paradigm but that seem useful in dealing with the complexities of human psychological problems.

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