Global Journal of Medical Research, A: Neurology & Nervous System, Volume 23 Issue 3

II. C urrent A pproaches to M ental I llness and H ow they W ork a) Psychological Interventions i. Supportive Psychotherapy Considered to be at the heart of all clinician- patient relationships, supportive psychotherapy encourages the patient to express his or her thoughts, feelings, and concerns in a safe, confidential, and nonjudgmental environment. Though helpful in treating almost any clinical condition, the precise mechanism (or mechanisms) through which supportive psychotherapy exerts its therapeutic effects are still not fully understood. However, its primary therapeutic mechanism appears to be stress-reduction. ii. Psychoanalytic Psychotherapy As the dominant form of therapy during the late 19th to mid20th centuries, psychoanalysis is aimed at helping patients resolve unconscious psychological conflicts by allowing them to become more aware of their unconscious thoughts, drives, and motives. The pioneer of this technique, Sigmund Freud, believed that as patients progressed, they became less stressed, less defensive, and, thus, less neurotic. However, the neurological correlates of these changes and their relationship to the patient’s symptoms are still unclear. iii. Interpersonal Psychotherapy (IPT) IPT focuses on relieving psychiatric symptoms by improving interpersonal functioning and social support. The central tenant of IPT is that psychiatric symptoms are the consequence of current difficulties in one’s relationships with others. Hence, the belief is that symptoms can be reduced by addressing current social stressors and helping patients develop healthier ways of relating to others. However, as with psychoanalytic psychotherapy, the effects of these changes on neurological function are still unclear. iv. Existential Psychotherapy Developed out of the philosophies of Friedrich Nietzsche and Søren Kierkegaard, existential psychotherapy hypothesizes that stress, frustration, and human discontent can be overcome through wisdom, willpower, and accepting personal responsibility. As a patient’s stress levels decline, so too will his or her psychiatric symptoms. However, the neurological mechanism through which the patient’s symptoms decline is still unknown. v. Cognitive-behavioral Therapy (CBT) CBT, which is commonly used for a wide range of mental health conditions, focuses on how one’s thoughts, beliefs, and attitudes affect their feelings and actions. By replacing one’s negative, self-defeating, and self-destructive thoughts with positive, self-affirming, and productive thoughts, one can reduce their psychiatric symptoms and literally change the way their brain processes information [2, 3]. However, the theory behind CBT does not answer the question of why some persons develop negative ways of thinking whereas others do not despite being raised in the same household by the same parents. It also fails to explain how the neurological changes that occur in conjunction with the observed cognitive and behavioral changes translate into a reduction of psychiatric symptoms. vi. Dialectic-behavioral Therapy (DBT) Based on the principles of CBT, DBT is specifically designed to help persons who experience their emotions too intensely. The DBT therapist helps the patient to combine opposing or “dialectic” cognitions and emotions to achieve a more positive way of thinking and feeling about things. In so doing, one’s stress levels and, thus, one’s psychiatric symptoms are reduced. However, DBT does not explain why, either psychologically or neuropsychiatrically, some persons experience their emotions more intensely. vii. Biofeedback Biofeedback attempts to reduce mental, emotional, and physical symptoms by teaching a person to control various functions of his or her body, such as heart rate, respiratory rate, and muscle tone. In theory, the meditative aspect of this discipline combines with a sense of empowerment over physical symptoms to reduce cognitive-emotional distress. Thus, biofeedback has the potential to reduce psychiatric symptoms as well as their associated physical symptoms. However, this treatment approach neither hypothesizes nor addresses the underlying cause of the symptoms. viii. Eye Movement Desensitization and Reprocessing (EMDR) Initially intended to help reduce symptoms of post-traumatic stress disorder, EMDR attempts to facilitate cognitive-emotional healing by alternately activating, with either voluntary eye movements or physical stimuli, the left and right sides of the body and then asking the patient to capture and hold in his or her mind, while the alternating stimulus is repeated, whichever thoughts and emotions were experienced. Although the mechanism by which EMDR exerts its therapeutic effects is not fully understood, the technique is thought to activate some of the same neurological recovery processes that occur during rapid eye movement (REM) sleep. ix. Mindfulness Meditation In mindfulness meditation, patients are asked to step back and reflect on the way they are thinking and feeling about individual emotional stressors and before they respond to them. This allows them to gain insight into their attitudes and behaviors and to develop a higher degree of self-discipline and self-control. Included in the technique are breathing exercises, guided imagery, and other practices that help relax the 2 Year 2023 Global Journal of Medical Research Volume XXIII Issue III Version I ( D ) A © 2023 Global Journals Untangling Psychology from Biology in the Treatment of Psychiatric Disorders