Most of us find that talking through problems with a friend will help us feel more relaxed and clearer in our minds. The various forms of psychotherapy can be seen as more formal versions of this type of communication offered by experienced professionals.
Psychotherapy – sometimes known as talking therapy – can be a powerful way of dealing with h problems. It can also help people to get to know themselves better so that they can cope better with life’s challenges. Sometimes, people feel put off by the very idea of psychotherapy – they may imagine that they will have to lie on a couch and be questioned about their innermost thoughts and feelings. In fact, most talking treatments are not like that at all. There are approximately 200 different types of psychotherapy of varying degrees of medical and scientific validity. What these therapies have in common is the attempt to establish a relationship – called the therapeutic relationship – between the individual and a trained professional. Whatever the therapy, it is this relationship between patient and therapist that is the crucial factor in resolving psychological problems.
Talking to a professional
it may seem a sad reflection of modern society that many people have to pay someone to talk about their problems. Surely a chat with a good friend or an older and wiser family member would be more helpful in a crisis? Social support is vital, of course, and it is known to alleviate stress and keep us healthy. But sometimes, a common-sense chat is not enough. Anyone who has suffered from clinical depression or a phobia will know that being told to ‘pull yourself together or ‘just do it by someone close makes them feel worse – however well-meant the advice. Often, friends and family are too close to an individual and their problems to offer objective and useful guidance. A qualified therapist, while he or she may be receptive and friendly, will take a more objective view.
These days, therapy is given by a wide range of professionals: psychiatrists, clinical psychologists, psychotherapists and counselors (who may or may not have medical qualifications), health visitors, and practice nurses. Standards and training vary, so check credentials before you embark on any form of therapy. It is not unknown for a counselor attached to a general practice to have had only brief training. Such people might be good at helping a client quit smoking or lose weight, but they may not be equipped to help someone suffering from the psychological problems that come with a serious illness such as cancer.
Two types of psychotherapy
Freud’s theory of psychoanalysis, which he developed towards the end of the 19th century, was the origin of the first talking therapy. Freud believed that psychological problems, such as depression, grew out of unconscious conflicts arising during childhood. Some of Freud’s patients who had physical disorders, such as back pain or speech problems, were apparently healed by psychoanalysis. In psychoanalysis, the person is made aware of unconscious residues of experience through the analysis of dreams and the free association of thoughts. Once in the conscious, many unconscious conflicts lose their stranglehold over the mind. As psychology and knowledge of the brain progressed during the 20th century, two different schools of psychotherapy emerged, broadly classified as psychodynamic therapies and supportive therapies. The psycho dynamic therapies focus on gaining insight into unconscious forces: they include Freudian psychoanalysis, Jungian therapy, and humanistic psycho therapy. The supportive therapies – including cognitive therapy, behavior therapy, and counseling – focus more on conscious thoughts and feelings and often involve an element of helping the patient to learn new behavior or thought patterns.
In general, psychodynamic therapies are more patient-centered, with the therapist taking a very non-directive role – some therapists offer very little in the way of comment or advice. Psychodynamic therapy normally lasts years, possibly involving several sessions a week. It is rarely available through health services. People who choose psychodynamic therapies may see themselves as ‘ psychologically minded’ or want to get to the root of a long-standing problem, such as chronic anxiety.
For an acute problem, such as an eating disorder, supportive therapy is usually more appropriate. With supportive therapies, there is far more of a two-way relationship between the patient and therapist. The therapist will ask more questions and may offer opinions and even advice (although no therapist should ever tell a patient what to do – it must always be the patient’s decision).
Group therapies
Psychotherapy is not always one-to-one; for certain problems, group therapy is more effective. Sharing experiences in a group can be genuinely beneficial. All too often, people are convinced that no one understands what it is like to have their problem, so when they discover that others share their feelings, it is often a great relief. People suffering from serious illnesses may meet together under the direction of a nurse or social worker to discuss their concerns. Family therapy is useful in dealing with childhood and adolescent behavioral problems, while couple therapy can help to untangle the complexities of a troubled relationship. Co- counseling takes place between two people within a group who take turns to be the rapist and client. If 1 person develops empathy with the co-counseling partner, the technique can be very helpful without the cost of a personal therapist. But the partners must stick to certain rules – no interrupting while the other person is speaking, no giving advice, and no passing judgment – and these can be difficult to follow. Observe yourself when you are next listening to a friend talk about his or her problems. How many times did you interrupt, perhaps to recount a similar experience of your own? Most people will gain so meth ing from talking therapy. However, for therapy to be successful, it is vital to match the type of therapy to the person and -the specific problem.
Therapy – Does It Work?
Psychologists have investigated the effectiveness of psychotherapy and have come to some broad conclusions based on data from various studies.
- Around 80 percent of people who have undergone therapy improve in some way, although some therapies are better suited to certain problems. Phobias and anxiety are most effectively treated with cognitive and behavioral approaches, while humanistic therapies are good for improving self-esteem. A study conducted in the US showed that the third or fourth visit to the therapist could predict the outcome of most treatments. By this stage, 3D-40 percent of clients had experienced some progress, while SQ-60 percent had felt some improvement by their seventh visit.
- The same data suggested that the longer a person went without change, the less likely it was for the therapy to be a success. The study suggested that treatment should be brief if there is no improvement within the first seven sessions. However, as long as patients are making some recordable progress, therapy should continue.
TYPES OF TALKING THERAPY
Psychodynamic therapies focus on the unconscious, while supportive therapies concentrate on conscious thought processes. Some of the main forms practiced include:
PSYCHODYNAMIC THERAPIES
- Freudian psychotherapy (psychoanalysis) seeks to uncover childhood sexual conflicts through the analysis of dreams.
- Jungian psychotherapy uses elements of mythology, symbols, and dreams to probe the mind.
- Adlerian psychotherapy fosters self-confidence by overcoming feelings of inferiority rooted in childhood.
- Kleinian psychotherapy focuses on early childhood experiences.
- Humanistic psychotherapy concentrates on spiritual growth potential, looking forward, not back.
- Rogerian psychotherapy is client centered and non-judgmental and assumes the patient is best able to deal with personal problems.
- Gestalt psychotherapy emphasizes integrating all aspects of experience, encouraging the patient to develop a full awareness of the present moment.
SUPPORTIVE THERAPIES
- Cognitive therapy aims to replace negative thought patterns with more logical and realistic ones.
- Behavioral therapy focuses on the immediate problem and the circumstances surrounding it.
- Rational-emotive therapy uses logic, authority, and persuasion to help the patient give up irrational ideas or unreasonable expectations.
- The transactional analysis examines the different roles a person plays in life (such as ‘child’ or ‘parent’ ) and helps the person develop a more realistic, constructive attitude.
- Counseling is often directed at specific problems – such as bereavement – and involves listening to clients and helping them to understand their problems.
- Counseling involves an equal relationship between two people who take turns talking and listening.
OTHER THERAPIES
- Group therapy is valuable where interpersonal difficulties are a key part of the problem.
- Family therapy is used where therapy directed at just one member of the family may not resolve matters.
- Art therapy involves painting, drawing, or sculpture to express emotions associated with a problem.
- Neurolinguistic programming(NLP) looks at how we experience the world and applies this knowledge to alter behaviors that limit us.
- Life coaching involves a personal coach who will help the individual to tackle specific problems. The coach discusses and monitors progress and sets goals.
- Eclectic approaches combine therapies to suit the individual’s character, circumstances, and problem.
