Measurement of Radiation and Dosimetric Procedure.pptx
Hanipsych, biology of psychotherapy
1.
2. Biology of Psychotherapy
Prof. Hani Hamed Dessoki, M.D.Psychiatry
Prof. Psychiatry,
Beni Suef University
Acting Dean, Faculty of Applied Medical Sciences
Beni Suef University
Supervisor of Psychiatry Department,
El-Fayoum University
4. Psychotherapy (Chapter 19)
First Lecture Outline:
History of psychotherapy
Psychotherapy approaches
Foundations of counselling
Video 101: Psychodynnamics
5. Meaning of
psychotherapy
• “A form of treatment for problems of an emotional
nature in which a trained person deliberately
establishes a professional relationship with a Patient
with the object of removing, modifying a retarding
existing symptoms of mediating disturbed patterns of
behavior and of promoting positive personality
growth and development”.
6. Jose Pons Madera, Ph.D. Director -
Psy.D. Program Ponce School of
Medicine Tel 844-5209
7. The therapist:
a trained person help to solve this type of
disturbance.
Empathy, unconditioned positive regard,
understanding, etc.
9. Goals of Psychotherapy
To change the maladaptive behavior of client,
To develop the interpersonal relationship,
To reduce inner conflict & personal tension,
To remove factors that maintain abnormalities,
To help to make adjustment with realities,
Development of self-identity & self-insight,
To facilitate the expressions of emotions,
Modifying the cognitive structure,
Facilitating decision-making.
11. What is a clinical interview?
• Psychotherapy involves talking to people
• Structured and unstructured interviews
• Model of psychotherapy directs attention of
interview
– Psychodynamic: Focus on early experiences
– Behavioral: Focus on symptoms, ABC’s
– Cognitive: Questions about specific thought
patterns
– Humanistic: Unconditional positive regard
12. Historical background:
Beliefs and treatment of the mentally ill
Greek physician Hippocrates (ca. 400BC)
promoted humane treatment. Tx based on
healing powers of nature: Mentally ill patients
were placed in pleasant surroundings and
given soothing baths.
Lack of balance between positive and negative
energies
Illness attributed to a disturbance in the
balance of bodily fluids (humorism).
Humour Season Organ Ancient name Modern MBTI Ancient characteristics
Blood spring liver sanguine artisan SP courageous, hopeful, amorous
Yellow bile summer spleen choleric idealist NF easily angered, bad tempered
Black bile autumn gall bladder melancholic guardian SJ despondent, sleepless, irritable
Phlegm winter brain/lungs phlegmatic rational NT calm, unemotional
13. What is Body Psychotherapy ?
Body-Psychotherapy is …
a scientifically validated, legitimate mainstream,
branch of psychotherapy, which historically
predates Psychoanalysis and Freud.
Body-Psychotherapy is …
an ethical and theoretically coherent
method of professional practice
for relieving emotional and mental distress
and for encouraging human growth.
and awareness..
14. Even more about Body-Psychotherapy
Body-Psychotherapy involves a developmental model;
a theory of personality; hypotheses as to the
origins of disturbances and significant alterations
to the human psyche; as well as a rich variety
of diagnostic and therapeutic techniques …
all used within the framework
of the therapeutic relationship.
16. Psychoneuroimmunology
• “Investigation of the bidirectional linkages between the
CNS, the endocrine system, and the immune system, and
the clinical implications of these linkages.”
• There are clear connections between the physiology that
underlies our emotional states and the immune system:
– direct neural connections
– Endocrine connections
• A matter of regulation correcting under and over
activation
17. Functions of the Immune system
• Discriminate self from foreign matter
• Destruction and clearance of foreign
substances
– Virus, bacteria, toxins that might enter body,
altered self (tumor cells)
• Ignore self - don’t destroy normal cells
• However:
• Autoimmune disease: system attacks itself
– GI and Joints (rheumatoid arthritis),
18. Key players of Immune sytem
• White Blood Cells (leukocytes)
– Polymorphonuclear granulocytes
• Neutrophils
• Eosinophils
• Basophils
– Lymphocytes develop in lymph nodes
• T,
• Helper- T
• B
• Natural Killer (NK) cells
– Monocytes – e.g. macrophages , dendritic cells
19. Where are they?
• Lymph nodes and vessels
• Bone morrow
• Thymus (T-cells)
• Spleen
• GI tract – to attack food borne pathogens
• Respiratory tract – for air borne pathogens
20. How can psychological events affect the
immune system?
• Classical Conditioning
• Activation of the HPA axis – cortisol secretion
• Activation of the Sympathetic Nervous System
- NE
21. “If you constantly mobilize energy, You
never store it; Your muscles waste
away; Your vascular system is under
constant pressure; and constant
Cortisol production turns off growth
factors and can harm every system
in the body…”
stress
22. Stress affects on Immune System
• HPA axis and cortisol (anti-inflammation)
• Stress causes dysregulated cortisol response
– Produces too much or too little
– Short term stressor – raises it
• Long term and long past stresses might result in
too low of cortisol – no inflammation suppression
– Flattens out the diurnal cycle of cortisol production
• Depressed pts. Have blunted cortisol effect –
don’t produce enough.
23. If stress causes Cortisol to be levels high:
• Inversely related to # of lymphocytes in blood
• Impairs immune function by
– decreasing IL-2
– Kills WBC
– Decreases tumor necrosis factor
– Decreases inflammation response
24. Stress effects
• Lab stressors (mental arithmetic) that causes NE
surges, increases NK cell activity. Short run
– Give beta blocker and effects is eliminated
• Other longer term stressors including exam
stress:
– Suppresses lymphocyte production (
• T-cell production
NK cell function
– “ production of interferon
– Reactivates latent viruses – herpes
– Lower antibody response to vaccinations
25. Anti-Inflammatory cytokines (IL-10,)
• Cytokines are regulators of host responses to
infection, immune responses, inflammation,
and trauma.
– Some cytokines act to make disease worse over
time (proinflammatory), whereas others serve to
– reduce inflammation and promote healing (anti-
inflammatory).
26. Stress and inflammations:
• Brief stressors increase pro-inflammatory
cytokines that can maintain a long term
inflammation response
• Stressors can lead to long term systemic
inflammatory responses
• BUT: does not mean that all systematic
inflammatons are due to psychological or
environmental stressors
27. Changing the Stress Response:
Protective Factors & Resiliency
(psychotherapy outcome)
• Feeling some degree of internal control;
• Exerting some control over your environment;
• Increasing your level of information and awareness;
• Changing your thoughts and perceptions;
• Shifting from mindless (unconscious) reaction to
mindful recognition;
• Creative solution-focused problem-solving;
• Support from others in our socio-familial environment;
• Not living alone !!
28. The Neuroscience of Empathy Fatigue: Our
Emotional Brain
• There are discrete, basic, and universal emotions that
persons react to on a M-B-S level;
• Emotions involve different body systems which arouse
our parasympathetic and sympathetic system;
• Chronic activation of the nervous system (stress
response) has both a physiological and emotional cost;
• 80% of all physical illness is cause by stress (Kabit-Zinn,
1990; Sapolsky, 1998; Selye, 1976; Weil, 1995)
29. Biology of Psychotherapy
• Yet growing evidence frombrain imaging
research suggests that the form of therapy
known as cognitive behavioral therapy, or CBT,
produces changes in the brain similar to those
produced by medications when they work.
• This "proof" of how a person's brain can be
transformed by therapy.
• Psychological interventions can profoundly
change a person's symptoms.
30. • Cognitive behavioral therapy emphasizes the role
our thoughts play in how we feel.
• Even if stressful external situations don't change,
changing how we think about them can prevent a
negative emotional response such as depression.
• The therapist's role is to help patients be more
rational in their assessment of such situations
and not make unwarranted worst-case-scenario
assumptions about them.
31. • It is a time-limited therapy that involves
active collaboration between patient and
therapist.
• Psychiatric conditions from depression
to panic disorder may benefit from CBT, but it
is research into its role in the treatment
of obsessive-compulsive disorder that has
yielded the most fascinating results.
32. • In a study that compared CBT to Prozac, researchers used a
brain-scanning technique called positron emission
tomography (PET) to measure the rate of glucose
metabolism in the OCD brain after Prozac treatment alone
and after therapy treatment alone.
• The results were essentially identical: both interventions
decreased the rate of glucose metabolism to levels seen in
healthy people without OCD, and the rate of the decrease
seemed proportional to the degree of improvement in their
OCD symptoms.
• Studies like this make CBT look like a biological treatment
similar to medications because it, too, can be seen to work
on the brain in ways that are objective and measurable.
And it's free of side effects.
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38. • Scientists have discovered several neurochemical and physiological events
underlying the three pillars of psychotherapy (attachment, empathy, and
fear extinction).
• Oxytocin, arginine vasopressin and the mu-opioid receptor all play a role
in controlling attachment.
• While receptor genes for oxytocin and the arginine receptor, as well as
activity in the anterior cingulate cortex and superior temporal sulcus
regulate empathy.
• Fear extinction appears regulated by the neurotransmitter NMDA, and
activity in the hippocampus, amygdala, and other brain regions.
• Antagonists (or agonists) of neurotransmitters may help enhance the
effects of psychotherapy, researchers speculate.
39. Biological marker
• A British and Australian study of
children receiving psychotherapy for anxiety
disorders responded differently to the therapy,
depending upon the allele of a serotonin
transporter gene promoter they carried.
• Children with one genotype (the “short short”
variety of the promoter) were significantly more
responsive to behavioral therapy than those with
another, “long” version.
40. • Studies have prompted biologists and
psychologists to look at whether genetic
variation and environmental influences can
provide biomarkers of a sort, predicting
whether a certain psychotherapy technique
could be effective.
41. • Psychotherapy could be enhanced by
combining “talk therapy” techniques with
drugs, genetic testing, and other
neurobiological tools to treat mood, anxiety,
or other psychological disorders.
• There’s even a new name for this new field:
“therapygenetics.”
