Psychobabble: Types of Psychotherapy
Author: Faith Hamby
Published on: October 27, 2000
It is not easy to get started in therapy. To begin with, there is the uncertainty about how to go about doing it. How to pick a therapist, what do you say when you go to one, and what do you have to do once you're in therapy? If you are thinking of therapy for yourself or someone you know, you probably feel anxious about starting off on a new experience in which a lot is at stake and the outcome is uncertain. You are not sure what is going to happen to you and how you are going to take to it. You might be worried about what other people are going to think of you. On top of all this, you have to overcome a certain amount of fear. Getting started means putting in some time and effort, it means planning and making a commitment.
A theory, in psychotherapy, is a little like looking through a camera with several different lenses. Depending on what lens you use, an image might be seen up close or from a wide angle. The image might be crisper or more diffuse. Most therapists choose one theory as the primary lens or point of view through which they view therapy and their patients.
The most common, and most popular theories a consumer will run into when trying to find a therapist are discussed below:
This is the daddy of them all. Remember those Psych 101 lectures from college about Freud? This is his baby. According to this therapy, our parents and our relationships with them are responsible for most of our troubles, albeit on an unconscious level. In psychodynamic therapy, the patient usually does a great deal of talking, known as psychoanalysis, while the therapist tries to help the patient become aware of connections between their relationship with their parents and their actions or motivations. Because this therapy assumes that people's motivations are basically unknown to them, or locked away in their unconscious, the therapist serves as a sort of psychological interpreter for the patient.
One of the most popular and common therapies, Cognitive-behavioral has been tested and proven effectual for conditions such as depression. This therapy is a little more broad-based than psychodynamic. While it still believes most of our problems stem for childhood, it focuses on childhood socialization whether it be with parents or other significant people in our early lives. By socialization, the theory basically means that we mimic and adopt behaviors and ways of thinking from prominent people in our lives. Unfortunately, we pick up good and bad, or irrational, behaviors. This therapy concerns itself with those irrational behaviors or negative spirals of thought learned from others. Here, the therapist helps the patient recognize irrational thoughts or actions, understand why they are irrational or negative and offers positive, alternative patterns of thought or behavior for the patient to practice.
This theory's a little like Jimmy Buffet's chorus in Margaritaville. You can say that there's someone else to blame for all your life problems, but really, you know it's your own damn fault. In humanistic theory, the patient is an individual, responsible for their own choices in life, regardless of their upbringing, their parenting, or their socialization. This theory promotes individualism, the person as a whole, and deals with some of the greater mysteries of life, such as, "Why are we here?" Humanistic therapy is more philosophical in nature than other theories, and the therapist acts as a guide through the patient's discovery of self and their role in the world around them.
Though most therapists will claim to be in one camp or the other--psychodynamic, cognitive, behavioral--most do not strictly or rigidly adhere to any one theory. This seems to be a growing trend. My own therapist describes herself as cognitive-based, but in my sessions, she's not only given me cognitive-behavioral exercises to work on my negative thinking, she's also stood back and taken a broader, humanistic view of what I need as an individual and a person. We also spent a chunk of sessions unraveling my relationships with my parents--a more psychoanalytical exercise, which helped me put those relationships into a new perspective. This combination of techniques defines eclecticism. Depending on the problem presented by the patient, a therapist may use one or more theories of psychotherapy to help the patient solve their dilemma. Eclecticism is not a mixed bag approach. Instead, it's a therapist's attempt to avail themselves of the beneficial practices of other theories in a way that best helps their patient.
When seeking out a therapist, it can be helpful to have a basic understanding of what theory of psychotherapy they practice. Someone who's heart begins to race every time they visit their mother and cringes at the thought of some small criticism from their parents, even when their parents are not present, may wish to choose a psychodynamic therapist who can help them see how their relationship with their parents may be causing them to second guess themselves. They may not be concerned with the larger, philosophical issues of their responsibility for their own anxiety that a humanistic therapist might choose to focus on.
But whatever theory your therapist subscribes to, the most important thing to remember is that your therapist is there to work for you, to help you, regardless of method. Make sure whatever your therapist does or proposes is in your best interest. Therapists are not like first loves. You can always find another.
WHAT IS PSYCHOTHERAPY?
Psychotherapy is a process aimed at helping you gain more control of your emotions through increased awareness, action, acknowledgment and acceptance of them and self-observation within the therapy relationship. It is a relationship in which a specially trained professional tries to help you overcome emotional pain and interpersonal problems. A variety of techniques are used based on your needs.
One major accomplishment in therapy is the expansion of the patient's capacity to contain pain, to postpone gratification--to suffer, yet to suffer without despair and without resorting to the multitude of defensive maneuvers. The successful therapeutic patient may experience greater degrees of suffering (in life) but more effectively tolerates it. Far from being merely a consolation, this is properly viewed on the contrary as a major value of reduced alienation and growth of the real self.
HOW LONG DOES IT TAKE?
It depends on the type of problems you are experiencing. A person with long standing difficulties which affect all areas of his or her life will need to be in therapy longer than someone with minor, situational problems. Time is needed to allow you to establish trust and to develop a working relationship. Psychotherapy may range from less than one year to three years.
WHAT IS THE CLIENT'S PART IN THE PROCESS? WHAT IS EXPECTED OF THEM?
You are expected to attend your sessions regularly and to work to express as many thoughts and feelings as possible - both about day to day issues and about the therapy relationship itself. Also, you may be given reading material or be asked to complete some writing assignments between sessions to further help you resolve the issues and problems you have presented.
ARE SESSIONS CONFIDENTIAL?
Absolutely. We do not discuss you or reveal any details about your therapy with anyone without your written permission. This includes other members in your family. The exception to this would be if you intend to harm yourself or someone else, which includes physical abuse and/or sexual abuse of children since we are required by law to take action and make a report to the appropriate agencies.
HOW IS CHILD PSYCHOTHERAPY DIFFERENT FROM THERAPY FOR ADULTS?
Psychotherapy for children is based on the same principles as adult therapy (awareness, education, acknowledgment, acceptance) but the techniques are different. Play is the natural language of children, not verbal expression. To help children express their feelings, the use of specialized toys, games, drawings and other "play" methods helps children resolve problems. The techniques used are matched to the specific needs and problems of the child, and requires specialized training and teaching for the therapist. The time required for psychotherapy may be the same with children and adults.
WILL THE PARENT BE INVOLVED IN THE CHILD'S THERAPY?
Absolutely. The therapist will probably want to meet with you on a regular basis to consult about changes as well as to find out how your child is managing both at home and at school. The therapist may need to meet with or talk with teachers or the pediatrician, but only with your written permission. As the parent, it is important to support your child's work with the therapist making sure that appointments are kept; offering encouragement as needed. To maintain trust, which is central to the therapy, we request that parents respect the confidentiality of their child's sessions and not press him/her for details of what is or is not talked about in the sessions. We give parents a list of helpful hints at the beginning of the child's therapy which will enhance the child's healing.
ARE MY CHILD'S SESSIONS CONFIDENTIAL?
Children deserve the same respect as adults about their therapy. It is important that we work together to help your child solve problems and to develop a positive self image. We will not tell you the specific content of your child's discussions either directly or through play unless there is some threat of self harm or harm to others. Immediate steps will be taken to protect the child's physical and emotional well-being.
WHAT ABOUT "COUPLES" THERAPY?
Often, couples benefit more from therapy together when they are experiencing conflicts. You can work together to make your relationship more open, to heal old wounds and to enhance your communication. Our job is to help you to find the way to develop a more healthy style of communicating and to develop a better way to resolve your conflicts together. We will give you specific assignments either writing or "thinking" tasks which will help you to develop new skills with each other.
WHAT ABOUT "FAMILY" THERAPY?
Whenever a member of a family begins to change, the whole family is affected. We might suggest a session or sessions with the whole family as a group, to help the family communicate better, heal old wounds and move toward a more compatible living arrangement.
WHAT IS "GROUP" THERAPY?
Group therapy can be especially helpful when the difficulties that you are experiencing are interpersonal, rather than intrapsychic. Group therapy can assist in the therapy process either in addition to individual sessions or by itself. Groups are working, therapeutic relationships, not social ones. The work is as hard as in individual therapy, but the benefits can be as great, or greater
What is the difference between Counseling and Therapy?
There is a considerable overlap in as much as both counseling and psychotherapy is about overcoming personal difficulties and facilitating change. The methods used are similar and in some instances identical. The differences relate more to the goals and interests and to the setting in which either professional works. Both will decide whether or not they should seek further medical and psychiatric advice and will normally make referrals to appropriate specialists whilst also making consultations with the client's GP. (Counseling & Psychotherapy Resources Directory 1995)
It is often considered that psychotherapy is more directive and looks to the past and the historical influences for the answers to 'here and now issues'. The counselor however may be seen to work more with crisis intervention. However the distinction between counseling and psychotherapy is not a matter that need concern those who seek help. It is not necessarily the case that those who seek counseling/ psychotherapy are presenting in a crisis situation, many come in order to improve aspects of themselves and their lives, to understand how they relate to others and to improve the quality of life.