Although there are many named types of psychotherapy, the most common and more frequently prescribed psychotherapies for individuals are the following:
- A combination of the above or Dialectic Behavioral Therapy or DBT
- A combination of cognitive and behavioral therapies or CBT
Psychodynamic psychotherapy is one of the most commonly prescribed and practiced forms of psychotherapy. It is based on the principles of psychoanalysis but is less intensive, usually occurring once or twice a week for a shorter period of time than psychoanalysis—often less than a year.
When many people think of psychotherapy, they actually think of psychoanalysis, which was developed by Sigmund Freud in the late 1800’s. Dr. Freud was the first clinician to develop a comprehensive theory of human consciousness, which he used to inform his development of the first psychotherapeutic technique and as well as the earliest tools of research into human consciousness. Thus, psychoanalysis is a theory of the mind, a method of treatment, and a method of research.
In psychoanalysis as a treatment, patients examine their conscious and unconscious thought processes, both past and present, to understand their current feelings and behavior. Psychoanalysis is a long-term, intensive therapy with a psychoanalyst. It involves several sessions a week and generally lasts for several years. Training to become a psychoanalyst requires a minimum of five years beyond other clinical training. It consists of a required personal analysis for the clinician in training, several years of classes, and professionally supervised clinical work with training and supervising analysts. Graduate psychoanalysts have undergone a final level of presentation and scrutiny of their work before receiving that title. Certified psychoanalysts have undergone yet another level of scrutiny of their knowledge and clinical work.
To return to psychoanalytic psychotherapy—such therapy is based on our knowledge that human behavior is strongly influence by one’s past experiences. Thus, just as in psychoanalysis, both past and present are areas of exploration; but the patient’s current situation generally is weighted more heavily in psychoanalytic psychotherapy. The goal of such work is to increase the patient’s awareness of unconscious thoughts and behaviors and help the patient to develop new insights into his or her feelings and motivations. This allows the patient to resolve conflicts and live a more productive and fulfilling life.
Therapists help patients explore life experience, confront, name, and master emotions, explore beliefs and actions, discuss relationships or patterns of behavior. Work in psychotherapy focuses on helping the patient make sense of thoughts and behaviors that initially don’t appear to make sense to the patient. Through that work, patients experience relief from the symptoms present at the beginning of treatment. This helps patients live happier, more satisfying and more productive lives.
Interpersonal psychotherapy focuses on a patient’s current life and relationships with an emphasis on learning how to evaluate the way the patient interacts with others. Goals include developing new strategies for dealing with relationships and examining and correcting communication problems. The relationship with the therapist becomes the template for examining other relationships. Common themes include unresolved grief, transitions for one social or occupational role to another, conflicts with significant people in the patient’s life, and difficulties in the patient’s capacity to relate to others. Although these themes are also the focus of psychodynamic psychotherapy, interpersonal psychotherapy approaches them in a more short-term format.
The aim of cognitive therapy is to identify and correct distorted thinking patterns that can lead to feelings and behaviors that may be troublesome, self-defeating, or even self-destructive. The goal is to replace such thinking patterns with more balanced views which, in turn, lead to more fulfilling and productive behavior. Cognitive therapy focuses on current problems with little or no attention to addressing underlying issues or past issues or conflicts. It generally involves homework between sessions. These exercises then become the focus of each succeeding session as patient and therapist try to replace maladaptive thinking patterns with more constructive ones.
This type of therapy focuses on changing unwanted or unhealthy behaviors through rewards, reinforcement, and desensitization. Desensitization, or exposure therapy is a process of confronting something that arouses anxiety, discomfort, or fear. The goal of the therapy is to overcome those unwanted responses. Behavioral therapy is often used for the treatment of obsessive-compulsive disorder or phobias. It often involves the cooperation of others, especially family or other close social contacts, to reinforce a desired behavior.
Cognitive Behavioral Therapy
Cognitive Behavioral therapy or CBT combines features of both cognitive and behavior therapies to identify unhealthy, negative thoughts and behaviors and to help the patient replace them with more productive, positive ones. It is based on the idea that one’s own thoughts, not other people or situations, determine how one behaves and that even if an unwanted situation doesn’t change, a person can change the way he or she thinks and responds to that situation. CBT generally minimizes exploration of underlying conflicts or issues from the past to remain centered on addressing maladaptive current behaviors and thoughts.
Dialectical Behavioral Therapy
Dialectical Behavioral Therapy or DBT was developed by Marsha Linehan, PhD at the University of Washington in Seattle. It draws from the principles of psychoanalytic, cognitive, behavioral, and interpersonal therapies. It has been demonstrated to be extremely effective in treating severe disorders that result from maladaptive interpersonal behaviors and from poorly developed self image or self esteem. It uses techniques from each of the above therapies and combines them with a focus on mindfulness, which is drawn from contemporary practices of stress management and meditation.
For more information…
Please visit these websites for more information about psychoanalysis and what it can do for you.
American Psychiatric Association, www.HealthyMinds.org
American Psychoanalytic Association, www.apsa.org
American Psychiatric Association, www.psych.org
The National Institute of Mental Health, https://www.nimh.nih.gov
Washington Center for Psychoanalysis http://www.wcpweb.org