Psychotherapy is often imagined as one lying on the couch and talking about problems while a bearded psychologist sits in the background, smoking a pipe and providing occasional insight. This visual isn’t far from the truth, although there isn’t always a couch, and the beard and pipe are completely optional. Psychotherapy does involve talking, though, and is sometimes referred to as “talk” therapy for this reason.
What is Psychotherapy?
Modern psychotherapy began in earnest with Sigmund Freud in the late 19th century, and the format has changed very little since then, even as the therapeutic techniques have evolved and a variety of theories have emerged as to the best way to treat the client. Today, there are a wide array of therapies to choose from, and for this reason psychotherapy sessions are highly individualized. The main focus is on the client/therapist relationship, and the strength of this relationship is central to psychotherapy’s effectiveness.
Anyone who feels stuck in unproductive or self-defeating behavior patterns can benefit from psychotherapy. Often, when we’re disabled by habitual behaviors that are blocking us from reaching our potential, we are unable to see it for ourselves, and talking with a therapist who can provide insight will help us to realize where we are stuck. Sometimes we gain insight simply from being in a place where we are allowed to talk about whatever comes to mind, and our subconscious will reveal itself to us as we open up. Certain types of psychotherapy have been shown to be highly effective for people with mild to moderate depression, anxiety, and issues involving stress, and for those with more severe forms of these disorders, psychotherapy can be a helpful supplemental tool along with medication or other physical interventions.
Types of Psychotherapy
There are many therapeutic techniques that fall under the umbrella of psychotherapy. While a therapist might find that one technique best suits an individual, generally the therapist will use a variety of techniques with each patient, depending on the problems being experienced by that person.
Behavior therapy focuses on changing the unwanted and self-defeating behavior patterns of the individual through conditioning. In essence, this technique involves the removal of undesirable habits and replacing that behavior with more satisfying and rewarding behavior. Behavior therapy can help an individual modify the stress response or overcome a crippling phobia.
Cognitive therapy looks at the underlying thought patterns and core beliefs behind unwanted feelings and emotions. The basic idea is that our thoughts about a situation are what create our emotions regarding that situation, and often our thoughts are based on irrational or troublesome core beliefs that we might not even be consciously aware of. An example would be a perfectionist who is suffering from anxiety because of all the pressure they put on themselves. Cognitive therapy can help this person see that they are too rigid in their thinking and that it is irrational to expect to be perfect at all times.
Cognitive-Behavioral therapy (CBT) is a combination of the above techniques and is the most popular therapy for dealing with depression and anxiety. The goal here is to simultaneously modify thoughts and behaviors to help the individual not only get beyond the negative core beliefs that are holding them back, but also to change the behavior patterns they have developed in response to those thought patterns. It is often our troublesome behavior that first brings us to therapy, and then, once the therapist has somewhat modified the behavior, the patient is in the position to work on changing the negative thoughts that create the unwanted behavior in the first place.
Dialectical Behavioral Therapy
Dialectical behavioral therapy, or DBT, brings together aspects of cognitive behavioral therapy (CBT), Zen teachings, and the dialectic of Greek philosophy. Because so many of the problems encountered by those with borderline personality disorder (BPD) are of an interpersonal nature, focus is placed on psychosocial therapy and skills training as well as medication and traditional psychotherapeutic interventions.
While DBT works well with BPD, it can also help with a wide range of what the counseling community calls “stinkin’ thinkin’.” It is our thoughts that shape our feelings and behaviors, and how we think has a lot to do with what happens in our lives. This is a theory used in DBT.
Gestalt therapy is based on the philosophy of existentialism and phenomenology; basically, it is essential to understand who we are in relation to all the things around us, and we must study and observe what is going on in the present moment in order to truly know ourselves. The saying, “Man is not an island unto himself,” would describe the Gestalt view of human understanding. Everything is interrelated, and one cannot understand themselves without simultaneously understanding the world around them at this time.
With Interpersonal Therapy, or IPT, the focus is on improving relationship skills such as communication and improving the supporting relationships in the depressed or anxious person’s life. By learning how to deal with loved ones in a more productive and less combative way, the individual can improve these relationships and reduce conflicts that might be contributing to their feelings of depression or anxiety.
Psychoanalysts guide the patient on a journey through their unconscious in order to uncover and understand internal conflicts that may be motivating emotional disturbances. Together, the therapist and client look at childhood problems, unconscious motivations, unresolved conflicts, and destructive behavior patterns to gain self-awareness and resolution. Freud is the father of psychoanalysis, but there are different schools of thought on how this technique should be used including the philosophies of Jung, Adler, Klein, and Sullivan.
There are different settings in which therapy can be performed. Individual therapy is just that—therapy sessions that are one-on-one between the therapist and the client. If a person dealing with depression or anxiety decides to seek therapy in a group setting, individual therapy may still be important as it gives that person the opportunity to speak in a safe environment. Family therapy and couples therapy involve working together as a family unit to help understand and deal with the problems within the family that are contributing to the problems of the depressed or anxious member. Often there are patterns at play within the family dynamic which deeply affect the recovery of one or more members, and this will be uncovered through therapy performed as a group. Group therapy brings together several people experiencing the same disorder so that they may share experiences and break the isolation so often associated with depression and anxiety.
Finding a Psychotherapist
In the world of psychotherapy, there are different types of therapists, and it’s important to understand the differences when looking for the right therapist for you. Many people initially turn to their general practitioner for help, and, while a general practitioner can prescribe medication or advise you on helpful lifestyle changes, they cannot perform psychotherapy. Even if you decide that medication is right for you, it’s important to also try to understand the root of the problem for long-term wellness. The following are some of the doctors and counselors that may help through the use of psychotherapy.
Psychiatrists are medical doctors trained in dealing with a variety of mental health issues including depression, anxiety, social anxiety disorder, and panic disorder. They can both perform psychoanalysis and prescribe medication if necessary. Often they investigate the possible biological factors including chemical imbalances and genetics through the use of tests, a look at medical history, and investigation of the family history. When necessary, psychiatrists may admit patients to the hospital for testing and observation.
Clinical Psychologists are not medical doctors, but they do have PhDs. They are able to diagnose and treat mental, behavioral, and emotional disorders, including short-term difficulties arising from crisis situations and long-term, chronic conditions. Most often they do this through the use of different psycho-therapeutic techniques. Because they are not medical doctors, psychologists are not able to prescribe medication, but they can refer the patient to someone who can if it is considered necessary.
Counseling Psychologists are PhDs who specialize in helping people to realize their personal strengths and resources in dealing with problems. They believe that individuals are just that—a unique set of traits that make up who they are, and they encourage us to celebrate the differences as strengths, not weaknesses. Counseling psychologists help the individual to realize how these differences can be used to help them discover their potential in professional and personal situations.
Licensed Professional Counselors have masters degrees in either psychology or counseling. Essentially, licensed professional counselors, or LPCs, aid the individual in dealing with problems that they have not been able to handle on their own. They focus on a broad spectrum of issues including grief and loss, family relationships, substance abuse problems, and stress management. In general, they first help the patient to devise a plan for resolving their issues and finding recovery. Once the plan is implemented, the LPC helps the patient maintain the resolution through continuing wellness plans.
Whatever type of psychotherapist you choose, there are a few things to keep in mind. First, trust yourself. Those with depression, anxiety, social anxiety, and panic disorder often don’t trust their feelings, and this may lead to their staying with a therapist that does not suit their needs. Shop around until you find someone with whom you are comfortable. Second, understand that therapy is a process. It is not a quick-fix or a cure-all, but it is an investment in your emotional wellness to come.