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Psychotherapy

psychotherapy inner page picPsychotherapy is a method of treating mild, moderate as well as severe psychological disturbances i.e. either disturbance in emotions or in behaviour or in both. We use cognitive behaviour therapy to treat almost all neurotic disorders as well as borderline psychotic disorders. Following are some psychological disorders which can be efficiently treated by our psychotherapists using psychotherapy.

Mood Disorders and psychotherapy:

Depressive Disorders/Bipolar Disorders and psychotherapy:

 

  • depressed mood most of the day
  • markedly diminished interest or pleasure in all activities
  • significant weight loss when not dieting or weight gain or decrease or increase in appetite
  • inability to sleep or inability to stay awake
  • fatigue or loss of energy nearly everyday
  • feelings of worthlessness or excessive or inappropriate guilt
  • diminished ability to think or concentrate, or indecisiveness
  • recurrent thoughts of death, recurrent suicidal ideation
  • distress or impairment in social, occupational, or other important areas of functioning
  • elevated, expansive, or irritable mood
  • inflated self-esteem or grandiosity
  • decreased need for sleep
  • more talkative than usual
  • flight of ideas or experience that thoughts are racing
  • distractibility
  • increase in goal-directed activity
  • excessive involvement in pleasurable activities that have a high potential for painful consequences

 

 

 

Anxiety Disorders and psychotherapy:

1) Panic Attack and psychotherapy:

In this disorder a person experiences a discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

  • palpitations, pounding heart, or accelerated heart rate
  • sweating
  • trembling or shaking
  • sensations of shortness of breath or smothering
  • feeling of choking
  • chest pain or discomfort
  • nausea or abdominal distress
  • feeling dizzy, unsteady, lightheaded, or faint
  • derealization (feelings of unreality) or depersonalization (being detached from oneself)
  • fear of losing control or going crazy
  • fear of dying
  • paresthesias (numbness or tingling sensations)
  • chills or hot flushes

2) Agoraphobia and psychotherapy

  1. In this disorder a person experiences anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed Panic Attack or panic-like symptoms. Agoraphobic fears typically involve characteristic clusters of situations that include:
  • being outside the home alone
  • being in a crowd or standing in a line
  • being on a bridge
  • traveling in a bus, train, or automobile
  1. These situations are avoided (e.g. travel is restricted) or else are endured with marked distress or with anxiety about having a panic attack or panic-like symptoms, or require the presence of a companion. Psychotherapy can improve the condition.

3) Specific Phobia and psychotherapy

  1. In this disorder there is marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of specific object or situation. For e.g.:
  • flying
  • heights
  • animals
  • receiving an injection
  • seeing blood
  1. Here exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed Panic Attack.

Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or clinging.

  1. The person recognizes that the fear is excessive or unreasonable.

Note: In children, this may be absent.

  1. The phobic situation (s) is avoided by the person or else is endured with intense anxiety or distress.
  2. The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person’s normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.

In individuals under age 18 years, the duration is at least 6 months. Psychotherapy can improve the condition.

4) Social Phobia (Social Anxiety Disorder) and psychotherapy

  1. In this disorder there is a marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing.
  2. Here exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally predisposed Panic Attack.

Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people.

  1. The person recognizes that the fear is excessive or unreasonable.

Note: In children, this may be absent.

  1. The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
  2. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person’s normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia. Psychotherapy can improve the condition.

5) Obsessive-Compulsive Disorder and psychotherapy

  1. This disorder is a combination of two.

Obsessions:

These are recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that caused marked anxiety or distress.

The thoughts, impulses, or images are not simply excessive worries about real-life problems.

The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.

The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind.

Compulsions:

Repetitive behaviours such as hand washing, ordering, checking or mental acts such as praying, counting, repeating words silently that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.

The behaviours or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviours or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

  1. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable.

Note: This does not apply to children.

  1. The obsessions or compulsions cause marked distress, are time consuming (take more than one hour a day), or significantly interfere with the person’s normal routine, occupational (or academic) functioning, or usual social activities or relationships. Psychotherapy can improve the condition.

6) Post Traumatic Stress Disorder and psychotherapy

  1. The person has been exposed to a traumatic event in which both of the following were present:

The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.

The person’s response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behaviour.

  1. The traumatic event is persistently re-experienced in one (or more) of the following ways:

Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.

Recent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.

Acting or feeling as if the traumatic event is recurring. This includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes. Note: In young children, trauma-specific reenactment may occur.

Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

  1. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

 

  • efforts to avoid thoughts, feelings, or conversations associated with the trauma
  • efforts to avoid activities, places, or people that arouse recollections of the trauma
  • inability to recall an important aspect of the trauma
  • markedly diminished interest or participation in significant activities
  • feeling of detachment or estrangement from others
  • restricted range of affect e.g. unable to have loving feelings
  • sense of a foreshortened future e.g. does not expect to have a career, marriage, children, or a normal life span

 

  1. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

 

  • difficulty falling or staying asleep
  • irritability or outbursts of anger
  • difficulty concentrating
  • hyper vigilance
  • exaggerated startle response

 

  1. Duration of the disturbance (symptoms in criteria B, C, and D) is more than one month.
  2. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Psychotherapy can improve the condition.

7) Acute Stress Disorder and psychotherapy

  1. The person has been exposed to a traumatic event in which both of the following were present:

The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.

The person’s response involved intense fear, helplessness, or horror.

  1. Either while experiencing or after experiencing the distressing event, the individual has three (or more) of the following dissociative symptoms:

 

  • a subjective sense of numbing, detachment, or absence of emotional responsiveness
  • a reduction in awareness of his or her surroundings (e.g. “being in a daze”)
  • derealization
  • depersonalization
  • dissociative amnesia (i.e. inability to recall an important aspect of the trauma)

 

  1. The traumatic event is persistently re-experienced in at least one of the following ways:

 

  • recurrent images,
  • thoughts,
  • dreams,
  • illusions,
  • flashback episodes
  • or a sense of reliving the experience
  • or distress on exposure to reminders of the traumatic event

 

  1. Marked avoidance of stimuli that arouse recollections of the trauma for e.g.

 

  • thoughts
  • feelings
  • conversations
  • activities
  • places
  • people

 

  1. Marked symptoms of anxiety or increased arousal for e.g.

 

  • difficulty sleeping
  • irritability
  • poor concentration
  • hypervigilance
  • exaggerated startle response
  • motor restlessness

 

  1. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or impairs the individual’s ability to pursue some necessary task, such as obtaining necessary assistance or mobilizing personal resources by telling family members about the traumatic experience.
  2. The disturbance lasts for a minimum of 2 days and a maximum of 4 weeks and occurs within 4 weeks of the traumatic event. Psychotherapy can improve the condition.

8) Generalized Anxiety Disorder and psychotherapy

  1. Here excessive anxiety and worry is seen, occurring more days than not for at least 6 months, about a number of events or activities such as work or school performance.
  2. The person finds it difficult to control the worry.
  3. The anxiety and worry are associated with three (or more) of the following six symptoms with at least some symptoms present for more days than not for the past 6 months. Note: Only one thing is required in children. Psychotherapy can improve the condition.

 

  • restlessness or feeling keyed up or on edge
  • being easily fatigued
  • difficulty concentrating or mind going blank
  • irritability
  • muscle tension
  • sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)

 

  1. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Psychotherapy can improve the condition.