Clinical Behavioral Medicine: Some Concepts and ProceduresThis book is an effort to integrate some clinical observations, theoretical concepts, and promising clinical procedures that relate psychological variables to physiological variables. My primary emphasis is on what psychological and behavioral concepts and procedures are most likely to enable us to influence physiological functions. The book covers ques tions that have fascinated me and with which I have struggled in daily clinical practice. What types of people are most at risk for physical disor ders or dysfunctions? Why do some people present psychosocial con flicts somatically and others behaviorally? What is the placebo effect and how does it work? How do you arrange the conditions to alter maladap tive belief systems that contribute to psychopathology and patho physiology? Do beliefs have biological consequences? When I was in private clinical practice, and even today in my medi cal school clinical practice situation, I set aside one day each week to puzzle over the theoretical questions that my clinical experience gener ates. Often isolating these underlying theoretical questions provides guidance into the most relevant empirical literature. I have found that this weekly ritual, which I started in private practice many years ago, appears to increase my clinical efficacy or at least makes clinical work more exciting. I find the unexamined clinical practice hard to endure. Kurt Lewin once said, "There is nothing so practical as a good theory. |
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Table des matières
| 1 | |
| 4 | |
| 5 | |
| 10 | |
| 14 | |
| 16 | |
| 19 | |
| 20 | |
References | 154 |
THE DIAGNOSIS AND PSYCHOPHYSIOLOGICAL MANAGEMENT OF CHRONIC PAIN AND ANXIETY | 155 |
Acute and Chronic Pain | 156 |
Illness Behavior Syndrome and Chronic Pain | 159 |
A Theory of the Acquisition of Chronic Pain and Anxiety | 160 |
Hypnotic Ability | 161 |
Negative Affectivity | 163 |
Rationales for the Use of Psychological and Behavioral Procedures with Pain | 164 |
| 21 | |
| 22 | |
| 24 | |
| 26 | |
| 33 | |
| 37 | |
| 41 | |
| 44 | |
| 45 | |
| 46 | |
| 47 | |
| 48 | |
| 55 | |
| 57 | |
| 58 | |
| 61 | |
| 64 | |
| 71 | |
| 73 | |
| 74 | |
| 79 | |
Crocks and Quacks | 85 |
Why Skills Taught by Psychotherapists May Be Promising Alternatives to Pills for Some Patients | 90 |
References | 93 |
WHAT IS THE PLACEBO EFFECT AND HOW DOES IT WORK? | 97 |
Theories of the Placebo | 100 |
Origins of the ConditionedResponse Model | 102 |
Unconditioned Stimuli | 105 |
Conditioned Stimuli | 106 |
The Placebo as a Conditioned Response | 107 |
Components of the Conditioned Placebo Response | 110 |
The CognitiveVerbal Component | 111 |
The Physicochemical Component | 112 |
Historical Aspects | 114 |
Acquisition Phase | 115 |
Consolidation Phase | 117 |
Placebo Responding | 118 |
Placebo Responding and Hypnotizability | 119 |
Parameters of Placebo Learning | 122 |
Phenomena of Conditioning | 124 |
Predictions from the Model | 125 |
Testing the Model | 128 |
Conclusion | 129 |
INITIAL PATIENT INTERVIEW | 135 |
Priorities and Procedures | 137 |
References | 142 |
PSYCHOPHYSIOLOGICAL ROLE INDUCTION OR THE TROJAN HORSE PROCEDURE | 143 |
Psychophysiological Demonstrations | 144 |
Educational Model | 147 |
CoInvestigator | 149 |
Out of the ClosetThe Psychotherapy Candidate | 150 |
Data on the Effects of the Psychophysiological Role Induction | 153 |
Hypnosis for Pain | 166 |
Biofeedback for Pain | 167 |
Behavior Modification for Pain | 171 |
Clinical Guidelines for a Psychophysiological Approach to a Chronic Pain Patient | 174 |
Role Induction for Chronic Pain Patients | 175 |
Case Study of a Chronic Pain Patient | 177 |
Summary and Conclusion | 179 |
References | 180 |
HIGHRISK PROFILE Assessment Patient Feedback and Therapy Planning Assessment Questions and Assumptions | 185 |
Discussion of Assessment Questions | 188 |
HighHypnotic Ability | 196 |
LowHypnotic Ability | 200 |
High Catastrophizing Panicking Cognitions | 202 |
Neuroticism Negative Affectivity and Excessive Sympathetic Reactivity | 205 |
Major Life Changes | 208 |
Hassles | 211 |
Support Systems | 212 |
Coping Skills | 215 |
Therapy Planning | 217 |
Case Study of a LowHypnoticAbility Patient | 218 |
Case Study of a HighHypnoticAbility Patient | 223 |
References | 229 |
SELFHYPNOSIS AND THE COMMON COMPONENTS OF OTHER STRESSREDUCTION TECHNIQUES A Theory | 233 |
Psychological Stress | 235 |
Common Procedural Components | 237 |
Common Therapeutic Mechanisms | 240 |
Allocentric Mode of Perception | 241 |
Cognitive Control of Physiology | 242 |
Sensory Restriction and Enhanced Hypnotizability | 243 |
Muscle Relaxation and Enhanced Hypnotizability | 245 |
Summary | 247 |
References | 248 |
APPENDIXES | 255 |
PROBLEMS WITH HYPNOSIS AND CRUCIAL CLINICAL CONCEPTS | 257 |
BRIEF PROCEDURES TO ASSESS HYPNOTIC ABILITY AND ATTITUDE | 259 |
UNOBTRUSIVE PROCEDURES | 265 |
EEC Alpha Density and Hypnotic Ability | 266 |
Experience Inventories | 269 |
WICKRAM EXPERIENCE INVENTORY | 271 |
Wickrams Modification of the Spiegel Hypnotic Induction Procedures | 275 |
INFORMAL CLINICAL TESTING FOR HYPNOTIC ABILITY WITH TEST SUGGESTIONS | 277 |
SUBJECTIVE RESPONSE INQUIRY | 281 |
WICKRAMASEKERAS DIAGNOSTIC INTERVIEW FOR HEADACHE | 283 |
HYPNOTIC PROCEDURE TO REDUCE HEADACHE PAIN | 285 |
IN VITRO DESENSITIZATION SD PROCEDURE | 287 |
BACKGROUND QUESTIONNAIRE | 289 |
BEHAVIORAL MEDICINE CLINIC AND STRESS DISORDERS RESEARCH LABORATORY Statement of Procedures | 291 |
BEHAVIORAL MEDICINE CLINIC AND STRESS DISORDERS RESEARCH LABORATORY Assessment for Admission | 293 |
PSYCHOPHYSIOLOGICAL PROFILE | 295 |
SELECTED BIBLIOGRAPHY | 297 |
INDEX | 301 |
Autres éditions - Tout afficher
Clinical Behavioral Medicine: Some Concepts and Procedures I.E. Wickramasekera Aucun aperçu disponible - 2013 |
Clinical Behavioral Medicine: Some Concepts and Procedures I.E. Wickramasekera Aucun aperçu disponible - 2013 |
Expressions et termes fréquents
active acute alter American anxiety appears approach associated attention behavior beliefs biofeedback biological changes chronic pain clinical cognitive complaints component conditioning coping demonstrated develop disease disorders drugs effects emotional evidence example experience Experimental eyes fact factors fear feelings Figure findings functions hand headache Hilgard hypnosis hypnotic ability hypnotic susceptibility hypnotizability important increase initial intensity International involves Journal learning least major measure mechanisms medicine mental muscle negative observations occur patient perception person physical physicians physiological placebo placebo effect positive potentiate practice predict present Press primary probably problems procedures psychological psychophysiological psychosocial psychotherapy reduce relationship relaxation reliably reported response risk role Scale Science score sensory situation skills sleep social somatic specific stimuli stress studies subjects suggestions symptoms techniques tension tests theory therapeutic therapist therapy tion treatment variables verbal Wickramasekera York
Fréquemment cités
Page 209 - You gain strength, courage and confidence by every experience in which you really stop to look fear in the face. You are able to say to yourself, "I lived through this horror. I can take the next thing that comes along." . . . You must do the thing you think you cannot do.
Page v - Two things fill the mind with ever new and increasing wonder and awe, the more often and the more seriously reflection concentrates upon them: the starry heaven above me and the moral law within me.
Page 241 - ... it is disadvantageous, however, to leave entirely in the hands of the patient what the mental factor in your treatment of him shall be. In this way it is uncontrollable ; it can neither be measured nor intensified. Is it not then a justifiable...
Page 33 - Inevitably the doctor's work in the future will be more and more educational and less and less curative. More and more will he deal with the physiology and psychology of his patient, less and less with his pathology. He will spend his time keeping the fit fit rather than trying to make the unfit fit.
Page 131 - Grant, DA A preliminary model for processing information conveyed by verbal conditioned stimuli in classical conditioning. In AH Black & WF Prokasy (Eds.), Classical conditioning II: Current theory and research.
Page 29 - Medicine, 60, 910-921. Medalie, JH, Snyder, M., Groen, JJ, Neufeld, HN, Goldbourt, U., & Riss, E. (1973). Angina pectoris among 10,000 men: 5 year incidence and univariate analysis.